Amanda Lopez-Picado1, Borja Barrachina2, Maria Remón3, Maria Errea4. 1. Araba Research Unit, Araba University Hospital, Bioaraba, Spain; Clinical Research and Clinical Trials Unit, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain. Electronic address: amanda.lopezpicado@gmail.com. 2. Department of Anaesthesia & Perioperative Care, Hospital Universitario Araba, Bioaraba, Spain. 3. Department of Anaesthesia & Perioperative Care, Hospital Garcia Orcoyen, Spain. 4. Office of Health Economics, London, UK.
Abstract
STUDY OBJECTIVE: To establish the best dose regimen for tranexamic acid (TXA) in total hip replacement surgery. DESIGN: Secondary analysis based on data from a multicenter double-blind randomized clinical trial. SETTING:Two hospitals in Spain. INTERVENTIONS:TXA (2 doses) versus placebo. PATIENTS: Consecutive adults who underwent uncemented unilateral total replacement hip surgery. MEASUREMENTS: We estimated the costs associated with TXA use (including consumables, drugs and nurse time) and allogeneic and autologous blood transfusions. For the cost-benefit analysis, we considered the spending on controls to estimate the benefits and the spending on patients in the intervention arms to estimate the costs. The net cost-benefit of TXA administration was calculated by subtracting the costs incurred per patient given TXA from the costs per patient given placebo. MAIN RESULTS: The median total costs per patient were €2.7 (2.4-3.0) in the single-dose group, €6.5 (6.5-7.1) in the two-dose group and €0 (0-190) in the control group (p = 0.001). The blood transfusion costs were €1607.8, €1041.8 and €3115.3 in the single-dose, two-dose and control groups, respectively. The administration of two doses of TXA achieved a greater net cost-benefit than a single dose, the difference being €566 in terms of overall costs. CONCLUSIONS: The administration of TXA is cost-effective, especially in the case of the two-dose regimen studied.
RCT Entities:
STUDY OBJECTIVE: To establish the best dose regimen for tranexamic acid (TXA) in total hip replacement surgery. DESIGN: Secondary analysis based on data from a multicenter double-blind randomized clinical trial. SETTING: Two hospitals in Spain. INTERVENTIONS:TXA (2 doses) versus placebo. PATIENTS: Consecutive adults who underwent uncemented unilateral total replacement hip surgery. MEASUREMENTS: We estimated the costs associated with TXA use (including consumables, drugs and nurse time) and allogeneic and autologous blood transfusions. For the cost-benefit analysis, we considered the spending on controls to estimate the benefits and the spending on patients in the intervention arms to estimate the costs. The net cost-benefit of TXA administration was calculated by subtracting the costs incurred per patient given TXA from the costs per patient given placebo. MAIN RESULTS: The median total costs per patient were €2.7 (2.4-3.0) in the single-dose group, €6.5 (6.5-7.1) in the two-dose group and €0 (0-190) in the control group (p = 0.001). The blood transfusion costs were €1607.8, €1041.8 and €3115.3 in the single-dose, two-dose and control groups, respectively. The administration of two doses of TXA achieved a greater net cost-benefit than a single dose, the difference being €566 in terms of overall costs. CONCLUSIONS: The administration of TXA is cost-effective, especially in the case of the two-dose regimen studied.
Authors: A Merchán-Galvis; M Posso; E Canovas; M Jordán; X Aguilera; M J Martinez-Zapata Journal: BMC Musculoskelet Disord Date: 2022-08-31 Impact factor: 2.562