Public access defibrillators cost €105m to save 50 lives

A plan to provide public access to defibrillators nationally would cost €105 million and save 50 lives over five years, according to a new report.

The Health Information and Quality Authority (Hiqa) says none of the public access defibrillator programmes it evaluated were cost effective.

It says if a national programme of public access defibrillator is introduced, it should only be considered in conjunction with measures to increase the use of defibrillators.

Former Minister for Health James Reilly commissioned the authority to undertake a health technology assessment of defibrillators after accepting the principal of a Bill published by independent senator Fergal Quinn.

The Public Health (Availability of Defibrillators) Bill 2013 requires the owners of 43,000 premises to install a defibrillator; among the designated places are hospitals, shops, churches, public buildings, pubs and sports clubs.

The assessment says a public access defibrillation programme has the potential to improve survival rates when people suffer cardiac arrest. However, a large number of additional defibrillators would be required, given the large number of people trained in CPR and uncertainty about where cardiac arrests occur.

It estimates a national system of public defibrillation could save the lives of between two and 10 people, over and above those who are treated in hospitals for cardiac arrest.

The greatest number of lives would be saved by a widespread public system of defibrillation, as proposed in the legislation, but this would cost €105 million.

Most of these costs would be incurred in the first year through the acquisition of defibrillators.

“Based on current data, none of the public access defibrillation programmes that we assessed would be considered cost-effective using conventional willingness to pay thresholds,” said Hiqa’s director of health technology assessment Dr Máirín Ryan.

The report says Ireland already has a high spread of defibrillators in the community, but this system is not standardised, coordinated or linked to emergency medical services. Between 8,000 and 10,000 defibrillators are available, many at high incidence locations where cardiac incidents are most likely to happen.

“Any prospective programme should start by targeting the mandatory deployment of defibrillators at locations with the highest incidence of out-of-hospital-cardiac-arrest,” Dr Ryan said.