{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T11:21:10Z","timestamp":1787829670088,"version":"build-2784847793"},"reference-count":31,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Around 60% of emergency department (ED) patients present with pain. With growing ED\u2010demand, there is need for analgesic options that reduce resource use and cost. We estimate the potential cost\u2010savings from broader use of inhaled methoxyflurane in Australian EDs compared with standard\u2010of\u2010care (SOC) analgesics or procedural sedation. The analysis focused on non\u2010admitted patient presentations requiring analgesia or procedural sedation to treat dislocations, burns, fractures and other injuries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cost\u2010minimisation analysis to assess differences in resource use and costs between methoxyflurane, and SOC. Model inputs were informed by a literature review, consultation with ED\u2010clinicians and Australian Institute of Health and Welfare data, adjusted to 2024\/25 population estimates. Costs are reported in 2024\/25 Australian dollars, per use case and on aggregate across Australian EDs. Intravenous ketamine, identified by clinicians as the most common comparator, was presented by indication. Sensitivity analyses were undertaken to assess robustness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Methoxyflurane use could have been associated with lower per\u2010patient costs than SOC, driven primarily by reduced ED length of stay and staff time. Estimated cost per use case ranged from $62\u2013$283 compared with intranasal fentanyl and $339\u2013$560 compared with intravenous ketamine. At a national level, this equated to potential annual ED\u2010operational efficiency gains of $9.5\u2013$42.9 million and $34.6\u2013$85.0 million, respectively. Methoxyflurane used for shoulder dislocations contributed an estimated $1.9\u2013$4.8\u2009million when compared to intravenous ketamine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Broader use of methoxyflurane for the management of pain and minor procedures in Australian EDs could deliver meaningful operational efficiency gains.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1742-6723.70326","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T13:04:19Z","timestamp":1787058259000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Inhaled Methoxyflurane in Australian Emergency Departments\u2014A Cost\u2010Minimisation Analysis"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-3991-7766","authenticated-orcid":false,"given":"Julius","family":"Ohrnberger","sequence":"first","affiliation":[{"name":"Sapere Research Group Limited  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Milkop","sequence":"additional","affiliation":[{"name":"Sapere Research Group Limited  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4013-3364","authenticated-orcid":false,"given":"George","family":"Braitberg","sequence":"additional","affiliation":[{"name":"Austin Health  Heidelberg Victoria Australia"},{"name":"Department of Critical Care University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0508-2450","authenticated-orcid":false,"given":"Biswadev","family":"Mitra","sequence":"additional","affiliation":[{"name":"The Alfred Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0760-1098","authenticated-orcid":false,"given":"Paul M.","family":"Middleton","sequence":"additional","affiliation":[{"name":"South Western Emergency Research Institute (SWERI), Liverpool Hospital  Liverpool New South Wales Australia"},{"name":"South Western Sydney Clinical Campuses, University of New South Wales  Warwick Farm New South Wales Australia"},{"name":"School of Medicine, Western Sydney University  Campbelltown New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue Anne","family":"Yee","sequence":"additional","affiliation":[{"name":"Medical Developments International  Scoresby Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julianne","family":"Alexander","sequence":"additional","affiliation":[{"name":"Medical Developments International  Scoresby Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/ajem.2002.32643"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ienj.2023.101272"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12093289"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742\u20106723.2011.01499.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.7573\/dic.212524"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/1742\u20106723.70113"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2025.04.021"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2018.01.011"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.2147\/OAEM.S181222"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12873\u2010023\u201000862\u20102"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/emermed\u20102022\u2010213042"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100034\u20101392366"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S252222"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12325\u2010020\u201001294\u20101"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.56929\/jseaortho\u20102024\u20100215"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S292521"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.3344\/kjp.2016.29.3.153"},{"key":"e_1_2_10_19_1","volume-title":"StatPearls","author":"Sadiq N. 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