From the Guidelines
Starting extracorporeal membrane oxygenation (ECMO) is a costly modality, but the exact cost is not specified in the provided studies 1. However, based on general knowledge, the cost of starting ECMO can range from $40,000 to $150,000 for initial setup, with daily operational costs ranging from $5,000 to $10,000. The total cost for a complete ECMO course often reaches $150,000 to $500,000 depending on duration, which averages 7-10 days but can extend to several weeks. Some of the key factors that contribute to the high cost of ECMO include:
- The ECMO circuit, which can cost approximately $25,000-$50,000
- Specialized cannulas, which can cost $1,500-$5,000 each
- Oxygenator membranes, which can cost $5,000-$15,000
- Dedicated staff, including specialized nurses, perfusionists, and physicians
- Medications, such as anticoagulants like heparin, sedatives, and vasopressors
- Intensive care unit expenses As noted in the studies, ECMO is a complex, high-risk, and costly modality that should be conducted in centers with sufficient experience, volume, and expertise to ensure it is used safely 1. The high cost of ECMO reflects the complex technology, specialized equipment, continuous monitoring, and highly trained personnel required for this life-saving intervention that temporarily takes over heart and/or lung function in critically ill patients. Hospital setting, geographical location, and patient-specific factors also significantly influence the final cost.
From the Research
Cost of Starting ECMO
- The cost of starting ECMO is not directly stated in the provided studies, but the cost-effectiveness of argatroban versus heparin anticoagulation in adult ECMO patients is discussed in one study 2.
- According to this study, the average cost per course of argatroban was less than the average cost per course of heparin ($7,091.98 vs $15,323.49, respectively) 2.
- However, the cost of ECMO itself is not mentioned in the studies, and the costs mentioned are only related to the anticoagulation therapy.
Anticoagulation Therapy Costs
- The costs of anticoagulation therapy with argatroban and heparin are compared in one study, with argatroban being potentially more cost-effective 2.
- The study found that argatroban was not associated with an increased incidence of bleeding, thrombotic, or ischemic events, making it a potentially viable alternative to heparin 2.
- Other studies discuss the use of argatroban as an anticoagulant in ECMO patients, but do not provide information on the cost of starting ECMO 3, 4, 5, 6.