06-13-2005, 04:52 AM
|
|
Registered User
|
|
Join Date: Jan 2003
Posts: 1,438
Thanks: 7
Thanked 115 Times in 67 Posts
|
|
|
Cost-effectiveness of recombinant human erythropoietin for reducing RBC Transfusion
| Value Health. 2005 Mar-Apr;8(2):105-16. | |
Cost-effectiveness of recombinant human erythropoietin for reducing red blood cells transfusions in critically ill patients.
MacLaren R, Sullivan PW.
School of Pharmacy, C238, University of Colorado Health Sciences Center, Denver, CO 80262, USA. rob.maclaren@uchsc.edu
OBJECTIVE: To examine the cost-effectiveness of using recombinant human erythropoietin (rHuEPO) to reduce red blood cells (RBC) transfusions in intensive care unit (ICU) patients. METHODS: Decision analysis examining costs and effectiveness of using rHuEPO versus not using rHuEPO in a simulated adult medical/surgical/trauma (mixed) ICU. Two independent cost-effectiveness models were created based on the results of two multicenter studies that investigated the use of rHuEPO. Base case assumptions and estimates of effectiveness were obtained from these two studies. Mean cumulative doses of rHuEPO were 190,900 units and 102,400 units for studies 1 and 2, respectively. The models accounted for the deferral rate for allogeneic RBC transfusions, rHuEPO efficacy (the reduction in allogeneic RBC use), and adverse effects of rHuEPO and allogeneic RBC transfusions. Model estimates were obtained from published sources. Costs were expressed in 2002 US dollar (dollars) and effectiveness was measured using discounted quality-adjusted life-years (QALYs). A 3% discount rate was used. Probabilistic sensitivity analysis was conducted using second-order Monte Carlo simulation. RESULTS: Incremental costs of using rHuEPO to reduce RBC transfusions amounted to 1918 dollars and 1439 dollars; incremental effectiveness values were 0.0563 QALYs and 0.0305 QALYs; and the cost-effectiveness ratios were 34,088 dollars and 47,149 dollars per QALY for studies 1 and 2, respectively. The model was most sensitive to the attributable risk of nosocomial bacterial infections per RBC unit. rHuEPO was cost-effective in 52.0% of the Monte Carlo simulations for a willingness to pay of 50,000 dollars/QALY. CONCLUSION: rHuEPO appears to be cost-effective for reducing RBC transfusions in heterogeneous ICU populations, assuming RBC transfusions increase the risk of nosocomial bacterial infections.
__________________
Mr. Jan B. Wade
Blood Management Consultant
Enhance Outcomes - Control Cost
For Information Call - 360 296-1807
Email
|
You are currently accessing this Site as a guest. Please login or register by clicking Here
Linear Mode
