Is BIS monitoring cost-effective?

BIS monitoring is a processed electroencephalogram (EEG) technology that is designed to follow the effects that anesthetics and sedatives have on cerebral function. Much is know about the technology, it's utility and limitations. The economic case for widespread utilization of this technology is weak. There appears to be little opportunity to decrease health care cost by either reduction of drug costs or improved practice efficiency. General use of BIS monitoring to reduce the incidence of intraoperative recall (IR) would cost about USD 10,000 to 25,000 per avoided IR. Total cost to the heath care system would approach one billion US dollars per year, just for use during general anesthetics. More appropriate use of already available drugs and technology would most likely decrease the incidence of IR as effectively, although individual patients who are at high risk for IR may benefit from this technology. However, based on current health care economic standards general use of BIS monitoring does not seem warranted and appears not to be cost-effective.