BresMed Netherlands, Utrecht, The Netherlands.
Ferring Pharmaceuticals, Copenhagen, Denmark.
J Med Econ. 2022 Jan-Dec;25(1):129-137. doi: 10.1080/13696998.2022.2027669.
To assess the cost-effectiveness of carbetocin versus oxytocin for the prevention of postpartum hemorrhage (PPH) following vaginal birth from the perspective of the UK National Health Service (NHS).
A decision tree model was designed to analyze the cost per PPH event avoided associated with utilizing carbetocin versus oxytocin for prophylactic treatment of PPH in women following vaginal birth from a UK perspective. It modelled the potential for women to require an additional uterotonic after prophylaxis, and to still experience a PPH event and receive associated treatment. Inpatient recovery and follow-up periods post-PPH were also included in the model. Costs associated with drug acquisition and administration, PPH management (i.e. additional staffing and possible operating theater and high dependency unit utilization), inpatient hospitalization, and follow-up visits were all considered. Adverse event management costs were not included. Resource utilization varied depending on the severity of the PPH event (as defined by the amount of blood lost). PPH events avoided were estimated. In an exploratory analysis, quality adjusted life years (QALYs) were estimated as well.
In the deterministic base case, costs were £55 lower and PPH events were 0.0342 lower per woman with carbetocin use compared to oxytocin use. Across the cohort of 100 women the reduction in PPH events led to the largest cost savings (£4,233 saved) out of all cost categories, with total cost savings of £5,495. Carbetocin utilization amongst the entire cohort led to 3.42 avoided PPH events compared to oxytocin utilization, comprised of 3.03 fewer mild/moderate PPH events and 0.39 fewer severe PPH events. Carbetocin utilization led to 0.0001 additional QALYs per woman.
Carbetocin utilization leads to lower prophylactic treatment costs and less PPH events versus oxytocin when utilized for the prevention of PPH following vaginal birth in the UK.
从英国国家医疗服务体系（NHS）的角度评估卡贝缩宫素与催产素预防阴道分娩后产后出血（PPH）的成本效益。
设计了一个决策树模型，以分析从英国的角度来看，卡贝缩宫素与催产素用于预防阴道分娩后 PPH 时，每避免一次 PPH 事件所产生的成本差异。该模型考虑了女性在预防措施后仍需额外使用宫缩剂且仍发生 PPH 事件并接受相关治疗的可能性。模型还包括 PPH 后的住院康复和随访期。考虑了与药物获取和管理、PPH 管理（即额外的人员配备和可能的手术室和高依赖单位使用）、住院治疗以及随访相关的成本。未包括不良事件管理成本。资源利用取决于 PPH 事件的严重程度（如失血量定义）。估计了避免的 PPH 事件数。在探索性分析中，还估计了质量调整生命年（QALY）。
在确定性基本情况下，与催产素相比，卡贝缩宫素的使用使每位女性的成本降低 55 英镑，PPH 事件减少 0.0342 次。在 100 名女性的队列中，所有成本类别中，PPH 事件的减少导致最大的成本节约（节省 4233 英镑），总节约成本为 5495 英镑。与催产素相比，卡贝缩宫素的使用在整个队列中避免了 3.42 次 PPH 事件，其中包括 3.03 次轻度/中度 PPH 事件和 0.39 次重度 PPH 事件的减少。卡贝缩宫素的使用使每位女性的 QALY 增加了 0.0001。
在英国，与催产素相比，卡贝缩宫素用于预防阴道分娩后 PPH 可降低预防性治疗成本并减少 PPH 事件。
