• Joachim Marti, Claire Hulme, Zenia Ferreira, Silviya Nikolova, Ranjit Lall, Charlotte Kaye, Michael Smyth, Charlotte Kelly, Tom Quinn, Simon Gates, Charles D Deakin, and Gavin D Perkins.
• Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, St. Mary's Campus, 10th Floor QEQM Building, 2 Praed Street, London W2 1NY, UK. Electronic address: j.marti@imperial.ac.uk.
• Resuscitation. 2017 Aug 1; 117: 1-7.

AimTo assess the cost-effectiveness of LUCAS-2, a mechanical device for cardiopulmonary resuscitation (CPR) as compared to manual chest compressions in adults with non-traumatic, out-of-hospital cardiac arrest.MethodsWe analysed patient-level data from a large, pragmatic, multi-centre trial linked to administrative secondary care data from the Hospital Episode Statistics (HES) to measure healthcare resource use, costs and outcomes in both arms. A within-trial analysis using quality adjusted life years derived from the EQ-5D-3L was conducted at 12-month follow-up and results were extrapolated to the lifetime horizon using a decision-analytic model.Results4471 patients were enrolled in the trial (1652 assigned to the LUCAS-2 group, 2819 assigned to the control group). At 12 months, 89 (5%) patients survived in the LUCAS-2 group and 175 (6%) survived in the manual CPR group. In the vast majority of analyses conducted, both within-trial and by extrapolation of the results over a lifetime horizon, manual CPR dominates LUCAS-2. In other words, patients in the LUCAS-2 group had poorer health outcomes (i.e. lower QALYs) and incurred higher health and social care costs.ConclusionOur study demonstrates that the use of the mechanical chest compression device LUCAS-2 represents poor value for money when compared to standard manual chest compression in out-of-hospital cardiac arrest.Copyright © 2017 Elsevier B.V. All rights reserved.

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