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Development of unmanned aerial vehicle (UAV) networks delivering early defibrillation for out-of-hospital cardiac arrests (OHCA) in areas lacking timely access to emergency medical services (EMS) in Germany: a comparative economic study
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    Comment on "Development of unmanned aerial vehicle (UAV) networks delivering early defibrillation for out-of-hospital cardiac arrests (OHCA) in areas lacking timely access to emergency medical services (EMS) in Germany: a comparative economic study"

    Although there is extensive scholarly interest in public access defibrillation, including a noteworthy strand of literature about drone delivery of automated external defibrillators (AEDs), cost-effectiveness assessments are still quite rare, and Bauer et al. [1] do well to combine cost considerations with national scope and attentiveness to geographic details. However, there is an inconsistency between the numerators and denominators in their incremental cost-effectiveness ratio (ICER) calculations, as will be discussed in this Rapid Response.

    Categories of cost included in Bauer et al.’s study include purchase and maintenance of drones (also known as unmanned aerial vehicles, UAV) and AEDs. These cost categories could be sufficient if the research or policy question being posed were focused on the minutes immediately following out-of-hospital cardiac arrest (OHCA)—for example, cost-effectiveness could be calculated per OHCA survival measured at the time of emergency department arrival. Instead, Bauer et al. follow more common practice and include in their denominators life-years saved—a longer-run value. As the authors notes: “The reference period for the [ICER] calculation was the first 12 years (mean life expectancy of OHCA survivor).” It is therefore necessary for twelve years’ worth of costs to be captured in ICER numerators.

    As noted in eTable 15 of Andersen et al. [2] and Table 2 of Kumar et al. [3], cost-effectiveness studies of public access...

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    Conflict of Interest:
    None declared.