Helen A van der Nelson1, Tim Draycott2, Dimitrios Siassakos2, Christopher W H Yau2, Anthony J Hatswell3. 1. Academic Centre for Women's Health, North Bristol NHS Trust, Bristol, United Kingdom; School of Clinical Sciences, University of Bristol, 69 St Michael's Hill, Bristol, BS2 8DZ, United Kingdom. Electronic address: helenvandernelson@gmail.com. 2. Academic Centre for Women's Health, North Bristol NHS Trust, Bristol, United Kingdom; School of Clinical Sciences, University of Bristol, 69 St Michael's Hill, Bristol, BS2 8DZ, United Kingdom. 3. BresMed, 84 Queen Street, Sheffield, S1 2DW, United Kingdom; Department of Statistical Science, University College London, Gower Street, London, WC1E 6BT, United Kingdom.
Abstract
OBJECTIVE: To determine the economic impact of the introduction of carbetocin for the prevention of postpartum haemorrhage (PPH) at caesarean section, compared to oxytocin. STUDY DESIGN: The model is a decision tree conducted from a UK National Health Service perspective. 1500 caesarean sections (both elective and emergency) were modelled over a 12 month period. Efficacy data was taken from a published Cochrane meta-analysis, and costs from NHS Reference costs, the British National Formulary and the NHS electronic Medicines Information Tool. A combination of hospital audit data and expert input from an advisory board of clinicians was used to inform resource use estimates. The main outcome measures were the incidence of PPH and total cost over a one year time horizon, as a result of using carbetocin compared to oxytocin for prevention of PPH at caesarean section. RESULTS: The use of carbetocin compared to oxytocin for prevention of PPH at caesarean section was associated with a reduction of 30 (88 vs 58) PPH events (>500ml blood loss), and a cost saving of £27,518. In probabilistic sensitivity analysis, carbetocin had a 91.5% probability of producing better outcomes, and a 69.4% chance of being dominant (both cheaper and more effective) compared to oxytocin. CONCLUSION: At list price, the introduction of carbetocin appears to provide improved clinical outcomes along with cost savings, though this is subject to uncertainty regarding the underlying data in efficacy, resource use, and cost. Crown
OBJECTIVE: To determine the economic impact of the introduction of carbetocin for the prevention of postpartum haemorrhage (PPH) at caesarean section, compared to oxytocin. STUDY DESIGN: The model is a decision tree conducted from a UK National Health Service perspective. 1500 caesarean sections (both elective and emergency) were modelled over a 12 month period. Efficacy data was taken from a published Cochrane meta-analysis, and costs from NHS Reference costs, the British National Formulary and the NHS electronic Medicines Information Tool. A combination of hospital audit data and expert input from an advisory board of clinicians was used to inform resource use estimates. The main outcome measures were the incidence of PPH and total cost over a one year time horizon, as a result of using carbetocin compared to oxytocin for prevention of PPH at caesarean section. RESULTS: The use of carbetocin compared to oxytocin for prevention of PPH at caesarean section was associated with a reduction of 30 (88 vs 58) PPH events (>500ml blood loss), and a cost saving of £27,518. In probabilistic sensitivity analysis, carbetocin had a 91.5% probability of producing better outcomes, and a 69.4% chance of being dominant (both cheaper and more effective) compared to oxytocin. CONCLUSION: At list price, the introduction of carbetocin appears to provide improved clinical outcomes along with cost savings, though this is subject to uncertainty regarding the underlying data in efficacy, resource use, and cost. Crown
Authors: Megan Dale; Sarah F Bell; Susan O'Connell; Cerys Scarr; Kathryn James; Miriam John; Rachel E Collis; Peter W Collins; Grace Carolan-Rees Journal: Pharmacoecon Open Date: 2022-09-06
Authors: Maria Fernanda Escobar; Anwar H Nassar; Gerhard Theron; Eythan R Barnea; Wanda Nicholson; Diana Ramasauskaite; Isabel Lloyd; Edwin Chandraharan; Suellen Miller; Thomas Burke; Gabriel Ossanan; Javier Andres Carvajal; Isabella Ramos; Maria Antonia Hincapie; Sara Loaiza; Daniela Nasner Journal: Int J Gynaecol Obstet Date: 2022-03 Impact factor: 4.447
Authors: Karen Pickering; Ioannis D Gallos; Helen Williams; Malcolm J Price; Abi Merriel; David Lissauer; Aurelio Tobias; G Justus Hofmeyr; Arri Coomarasamy; Tracy E Roberts Journal: Pharmacoecon Open Date: 2019-06
Authors: Sophie Relph; Louisa Delaney; Alexandra Melaugh; Matias C Vieira; Jane Sandall; Asma Khalil; Dharmintra Pasupathy; Andy Healey Journal: BMJ Open Date: 2020-10-30 Impact factor: 2.692