Stocking dantrolene saves lives and money
Storing the drug at ASCs very cost effective
Storing dantrolene would save 33 lives per year at an incremental cost-effectiveness ratio of nearly $200,000 (in 2010 dollars) per life saved, indicating that storing dantrolene at ambulatory surgical centers (ASCs) is very cost effective, say malignant hyperthermia experts.
"Anesthesia safety in ambulatory surgery centers is understudied and remains a serious concern," says Guohau Li, MD, PhD. "Our study indicates that requiring ambulatory surgery centers to stockpile dantrolene as recommended by Malignant Hyperthermia Association of the United States [MHAUS] is a cost-effective measure for treating malignant hyperthermia — an infrequent but potentially fatal complication. It will save lives and money." Li coauthored the article "Cost-effectiveness analysis of stocking dantrolene in ambulatory surgery centers" that recently was published in Anesthesiology. To access the abstract, go to http://bit.ly/1i8WTfU.
Dantrolene is the only specific treatment for malignant hyperthermia (MH). MHAUS has issued guidelines recommending that 36 vials (20 mg per vial) of dantrolene remain in stock at every surgery center.
A decision tree model was used to compare treatment with dantrolene to a supportive care-only strategy. Model assumptions include the incidence of MH, MH case fatality with dantrolene treatment, and MH case fatality with supportive care-only. Sensitivity analyses were performed to assess the robustness of the estimated cost-effectiveness.
The estimated annual number of MH events in U.S. ASCs was 47. The incremental effectiveness of dantrolene compared with supportive care was 33 more lives saved per year. The incremental cost-effectiveness ratio was $196,320 (in 2010 dollars) per life saved compared with a supportive care strategy.
The results of this analysis suggest that stocking dantrolene for the treatment of MH in ASCs is cost-effective when compared with the estimated values of statistical life used by U.S. regulatory agencies.