Cost-Effectiveness of a Shock Team Approach in Refractory Cardiogenic Shock

Area of Science:

• Cardiology
• Health Economics
• Healthcare Management

Background:

• Multidisciplinary Shock Teams enhance cardiogenic shock patient outcomes.
• The cost-effectiveness of Shock Teams has not been previously evaluated.
• This study aims to compare costs and determine the economic value of Shock Teams versus standard care.

Purpose of the Study:

• To compare the costs associated with treating cardiogenic shock patients with and without a Shock Team.
• To assess the cost-effectiveness of implementing a Shock Team compared to the standard of care.

Main Methods:

• Retrospective analysis of 244 patients with refractory cardiogenic shock (2009-2018).
• Comparison of costs, survival rates (discharge, 1-year), and quality-adjusted life years (QALYs) gained at 1 year.
• Calculation of incremental cost-effectiveness ratios (ICERs) and probabilistic sensitivity analysis (PSA) with 1000 simulations.

Main Results:

• The Shock Team approach significantly improved survival rates at discharge (61.0% vs. 47.9%) and 1-year follow-up (55.0% vs. 40.5%).
• ICERs were $102,088 per survival increase at discharge and $96,152 per survival increase at 1 year.
• The Shock Team was cost-effective in most simulations, particularly with a willingness-to-pay threshold of $150,000, and dominant in nearly one-third of simulations.

Conclusions:

• The Multidisciplinary Shock Team approach represents a potentially cost-effective strategy for managing refractory cardiogenic shock.
• Findings support the prioritization of Shock Team implementation to improve patient survival and quality of life.
• This economic evaluation provides evidence for healthcare providers and policymakers regarding Shock Team benefits.