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Cost identification analysis for succinylcholine.

F Dexter1, T J Gan, M Naguib

  • 1Department of Anesthesia, University of Iowa, Iowa City, Iowa 52242, USA. franklin-dexter@uiowa.edu

Anesthesia and Analgesia
|February 28, 2001
PubMed
Summary
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The societal cost of succinylcholine is over 20 times its acquisition price, primarily due to severe adverse reactions. Better data on anaphylaxis incidence and outcomes are needed for precise cost estimation.

Area of Science:

  • Pharmacoeconomics
  • Drug safety evaluation
  • Societal cost analysis

Background:

  • Succinylcholine is a widely used neuromuscular blocking agent.
  • Its acquisition cost is low, but potential adverse outcomes may significantly increase its societal cost.

Purpose of the Study:

  • To determine the total societal cost per dose of succinylcholine.
  • To compare the societal cost with its acquisition cost.

Main Methods:

  • Literature review to identify adverse outcomes of succinylcholine.
  • Cost analysis incorporating drug acquisition and costs of adverse events (death, brain injury).
  • Focus on non-emergency adult use as per manufacturer guidelines.

Main Results:

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  • Anaphylactic or anaphylactoid reactions accounted for 88% of the cost per dose.
  • Estimated cost per dose ranged from $9 to $93, with a best estimate of $37.
  • The societal cost is over 20 times the acquisition cost.

Conclusions:

  • The true societal cost of succinylcholine is substantially higher than its acquisition cost.
  • Cost estimation is highly sensitive to the incidence and severity of anaphylactic/anaphylactoid reactions.
  • Further research on succinylcholine-induced anaphylaxis is warranted.