{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T16:24:26Z","timestamp":1783527866253,"version":"3.55.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100030785","name":"Getinge","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100030785","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001826","name":"ZonMW","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Extracorporeal cardiopulmonary resuscitation (ECPR) can restore circulation in refractory out-of-hospital cardiac arrest (OHCA). A trial-based analysis with a 1-year horizon showed limited cost-effectiveness of this demanding procedure. However, arguably, long-term incremental health benefits may justify high initial incremental costs. We assessed the cost-effectiveness of ECPR compared with conventional cardiopulmonary resuscitation (CCPR) for OHCA with a lifetime horizon using trial-based data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Healthcare and societal costs and quality adjusted life years (QALY), assessed using EQ-5D-5L, were simulated over a 20-year period following ECPR or CCPR for OHCA using a Markov model. Data from the per-protocol population of a multicentre randomized controlled trial comparing ECPR with CCPR were used as input parameters. The incremental cost-effectiveness ratio (ICER) was expressed as Euros per QALY. Probabilistic and deterministic sensitivity analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We used data from 33 ECPR and 47 CCPR patients. Mean \u00b1 SD costs after 1 year were \u20ac26.372 \u00b1 28.237 vs. \u20ac10.356 \u00b1 37.706, and survival was 15% vs. 9% in patients treated with ECPR vs. CCPR. Over a lifetime horizon, mean incremental costs and QALYs of ECPR were \u20ac160.969 and 0.66, respectively, resulting in an ICER of \u20ac242.122\/QALY. At a willingness-to-pay threshold of \u20ac80.000 per QALY gained, the probability of ECPR being cost-effective was 46%. The costs of non-survivors in both arms and the QALYs gained were the major drivers of the ICER.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Extracorporeal cardiopulmonary resuscitation for refractory OHCA has a low probability of being cost-effective. To enhance cost-effectiveness, improving ECPR effectiveness and reducing hospital costs of ECPR non-survivors are mandatory.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjacc\/zuag058","type":"journal-article","created":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T11:33:22Z","timestamp":1776166402000},"page":"516-523","source":"Crossref","is-referenced-by-count":0,"title":["Cost-effectiveness of extracorporeal CPR for out-of-hospital cardiac arrest: a trial-based Markov model with a lifetime horizon"],"prefix":"10.1093","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-8279-0590","authenticated-orcid":false,"given":"Anina F","family":"van de Koolwijk","sequence":"first","affiliation":[{"name":"Department of Intensive Care Medicine, Maastricht University Medical Center+, Maastricht University , Maastricht ,","place":["The 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Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stijn E D M","family":"Eussen","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Maastricht University Medical Center+, Maastricht University , Maastricht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigitte A B","family":"Essers","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Medical Technical Assessment, Maastricht University Medical Center+, Maastricht University , Maastricht ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annemieke","family":"Oude Lansink-Hartgring","sequence":"additional","affiliation":[{"name":"Department of Critical Care, University Medical Center Groningen , Groningen ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renicus C","family":"Hermanides","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Isala Clinics , Zwolle ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8510-8648","authenticated-orcid":false,"given":"Luuk C","family":"Otterspoor","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Catharina Hospital , Eindhoven ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos V","family":"Elzo Kraemer","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Leiden University Medical Center, Leiden University , Leiden ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3453-7186","authenticated-orcid":false,"given":"Alexander P J","family":"Vlaar","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Amsterdam University Medical Center, University of Amsterdam , Amsterdam ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joris J","family":"van der Heijden","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, University Medical Center Utrecht, Utrecht University , Utrecht ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Scholten","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, St. Antonius Hospital , Nieuwegein ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corstiaan A","family":"den Uil","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Erasmus Medical Center, Erasmus University , Rotterdam ,","place":["the Netherlands"]},{"name":"Department of Cardiology, Erasmus Medical Center, Erasmus University , Rotterdam ,","place":["the 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