Joshua P Vogel1,2, Alyce N Wilson1, Nick Scott1,2, Mariana Widmer3, Fernando Althabe3, Olufemi T Oladapo3. 1. Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Vic., Australia. 2. School of Population Health and Preventative Medicine, Monash University, Melbourne, Vic., Australia. 3. UNDP/UNFPA/UNICEF/WHO/World Bank Special Program of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
Abstract
BACKGROUND: Uterine tamponade is widely promoted for treating refractory postpartum hemorrhage (PPH); however, its cost-effectiveness may vary depending on unit costs and setting. OBJECTIVE: To review available data on cost-effectiveness of uterine tamponade devices when used for PPH treatment. SEARCH STRATEGY: PubMed and EMBASE were searched (1980 to January 2020), as well as the National Health Services Economic Evaluation database from inception (1995) to March 2015. SELECTION CRITERIA: Eligible studies were any type of economic evaluation, or effectiveness studies that provided cost or economic data. DATA COLLECTION AND ANALYSIS: Two reviewers independently screened studies, extracted data, and assessed quality. MAIN RESULTS: Eleven studies using a range of devices (condom catheter, uterine suction devices, Bakri, Inpress, Ellavi) were identified. Cost of condom catheter devices or kits ranged from US$0.64 to US$6, whereas purpose-designed device costs were up to US$400. Two studies that took a health system perspective assessed the cost-effectiveness of using uterine balloon tamponade and suggested that it was highly cost-effective because of the low cost per disability-adjusted life-year averted, although both used effect estimates from case series. CONCLUSIONS: Evidence on the cost-effectiveness of uterine tamponade devices was limited and not generalizable. Rigorous economic evaluations based on updated effect estimates are needed.
BACKGROUND: Uterine tamponade is widely promoted for treating refractory postpartum hemorrhage (PPH); however, its cost-effectiveness may vary depending on unit costs and setting. OBJECTIVE: To review available data on cost-effectiveness of uterine tamponade devices when used for PPH treatment. SEARCH STRATEGY: PubMed and EMBASE were searched (1980 to January 2020), as well as the National Health Services Economic Evaluation database from inception (1995) to March 2015. SELECTION CRITERIA: Eligible studies were any type of economic evaluation, or effectiveness studies that provided cost or economic data. DATA COLLECTION AND ANALYSIS: Two reviewers independently screened studies, extracted data, and assessed quality. MAIN RESULTS: Eleven studies using a range of devices (condom catheter, uterine suction devices, Bakri, Inpress, Ellavi) were identified. Cost of condom catheter devices or kits ranged from US$0.64 to US$6, whereas purpose-designed device costs were up to US$400. Two studies that took a health system perspective assessed the cost-effectiveness of using uterine balloon tamponade and suggested that it was highly cost-effective because of the low cost per disability-adjusted life-year averted, although both used effect estimates from case series. CONCLUSIONS: Evidence on the cost-effectiveness of uterine tamponade devices was limited and not generalizable. Rigorous economic evaluations based on updated effect estimates are needed.
Authors: Atef M Darwish; Mohamed M Abdallah; Omar M Shaaban; Mohammed K Ali; Mohamed Khalaf; Ali Mohamed A Sabra Journal: J Matern Fetal Neonatal Med Date: 2017-03-08
Authors: Joshua P Vogel; Therese Dowswell; Simon Lewin; Mercedes Bonet; Lynn Hampson; Frances Kellie; Anayda Portela; Maurice Bucagu; Susan L Norris; James Neilson; Ahmet Metin Gülmezoglu; Olufemi T Oladapo Journal: BMJ Glob Health Date: 2019-08-19