Henríquez-Trujillo Aquiles Rodrigo, Lucio-Romero Ruth Alicia, Bermúdez-Gallegos Kerlly
Facultad de Ciencias de la Salud, Universidad de Las Américas, Quito, Ecuador.
Sur-Este, Grupo de Investigación en Economía de la Salud y Excelencia Clínica, Quito, Ecuador.
J Comp Eff Res. 2017 Sep;6(6):529-536. doi: 10.2217/cer-2017-0004. Epub 2017 Sep 8.
To compare the cost of carbetocin with that of oxytocin for the prevention and management of hemorrhage following cesarean delivery in Ecuador.
MATERIALS & METHODS: We developed a decision tree based cost-effectiveness model to compare carbetocin with oxytocin in the prevention of hemorrhage following cesarean delivery in Ecuador. Our model was run from a third party payer perspective and was validated by local experts in the field. The efficacy of the interventions was determined based on a systematic review of the literature. Direct costs were calculated based on current National Health Service price lists and retail price. Since the period covered by the analysis was 1 year, costs and health effects were not discounted.
The difference in costs between the interventions was US$16.26, with a difference in effectiveness of 0.0067 disability adjusted life years averted. The incremental cost-effectiveness ratio for carbetocin compared with oxytocin for prevention of hemorrhage following cesarean delivery was US$2432.89 per disability adjusted life year averted.
Carbetocin is as efficacious and safe as oxytocin for primary prevention of hemorrhage in cesarean delivery in Ecuador. It is highly cost effective for reducing the need for additional uterotonic drugs in both emergency and elective cesarean delivery.
比较卡贝缩宫素与缩宫素在厄瓜多尔剖宫产术后预防和处理出血方面的成本。
我们建立了一个基于决策树的成本效益模型，以比较卡贝缩宫素与缩宫素在厄瓜多尔剖宫产术后预防出血方面的效果。我们的模型从第三方支付者的角度运行，并由该领域的当地专家进行验证。干预措施的疗效基于对文献的系统评价来确定。直接成本根据当前国家卫生服务价格表和零售价格计算。由于分析涵盖的时间段为1年，成本和健康效果未进行贴现。
两种干预措施之间的成本差异为16.26美元，有效率差异为避免0.0067个伤残调整生命年。与缩宫素相比，卡贝缩宫素预防剖宫产术后出血的增量成本效益比为每避免一个伤残调整生命年2432.89美元。
在厄瓜多尔，卡贝缩宫素在剖宫产术中预防出血方面与缩宫素一样有效且安全。在急诊和择期剖宫产中，它在减少额外宫缩剂药物需求方面具有很高的成本效益。
