Abstract 16298: Cost-Effectiveness Analysis of Public-Access Automated External Defibrillators in Japan
Rationale: The number of public-access automated external defibrillators (AEDs) has increased rapidly since their use became legal for any citizen in Japan in 2004. However, few studies have provided economic evaluations of AEDs in Japan. This study aimed to estimate the cost-effectiveness of AEDs in Japan.
Methods: Total cost of AEDs was estimated from the number of AEDs installed in Japan and unit cost per AED. Unit cost per AED was estimated assuming that all units and disposables are replaced when the service life is over. Effectiveness of AED was estimated by the cerebral performance category (CPC) scale in a prospective nationwide population-based database of out-of-hospital cardiopulmonary arrest (OHCA) in Japan. CPC scale was converted to quality-adjusted life-year (QALY) by conversion indexes developed in existing studies. Incremental cost-effectiveness ratio (ICER) was estimated from the total cost and effectiveness of AEDs.
Results: In total, 251,030 AEDs were installed in Japan from 2005 to 2010. The total cost of all AEDs was estimated at JPY 82.1 billion (US$ 0.9 billion). AEDs were operated for 3,954 OHCA cases in this period. AED-treated OHCA cases had better outcomes than non-AED-treated cases: 28.8% and 3.4% of cases with CPC1 respectively. Incremental QALY gains per AED usage were estimated at 2.1 - 2.2 per case. ICER of AEDs was estimated at JPY 9.5 million (US$ 105,000).
Discussion: The present data indicate that QALY gains per AED usage are higher than that in existing studies. This is a nationwide study using larger sample compared with previous studies and provided much detailed estimation using CPC scale. There are wide variations of ICER of AEDs in existing studies. The results of this research indicate that the cost-effectiveness of AEDs in Japan is in the range of those in the existing studies. It is, however, possible to improve the cost-effectiveness of AEDs in Japan for reducing costs and improving AED usage by expanding AED training opportunities.
- © 2012 by American Heart Association, Inc.