Cost-effectiveness of Carbetocin versus Oxytocin for Prevention of Postpartum Hemorrhage Resulting from Uterine Atony in Women at high-risk for bleeding in Colombia
Abstract Objective To assess the cost-effectiveness of carbetocin versus oxytocin for prevention of postpartum hemorrhage (PPH) due to uterine atony after vaginal delivery/ cesarean section in women with risk factors for bleeding. Methods A decision treewas developed for vaginal delivery andanot...
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| Format: | Article |
| Language: | English |
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Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
2018-05-01
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| Series: | Revista Brasileira de Ginecologia e Obstetrícia |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032018000500242&tlng=en |
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| author | Yaneth Gil-Rojas Pieralessandro Lasalvia Fabián Hernández Camilo Castañeda-Cardona Diego Rosselli |
| author_facet | Yaneth Gil-Rojas Pieralessandro Lasalvia Fabián Hernández Camilo Castañeda-Cardona Diego Rosselli |
| author_sort | Yaneth Gil-Rojas |
| collection | DOAJ |
| description | Abstract Objective To assess the cost-effectiveness of carbetocin versus oxytocin for prevention of postpartum hemorrhage (PPH) due to uterine atony after vaginal delivery/ cesarean section in women with risk factors for bleeding. Methods A decision treewas developed for vaginal delivery andanother one for cesarean, in which a sequential analysis of the results was obtained with the use of carbetocin and oxytocin for prevention of PPH and related consequences. A third-party payer perspective was used; only directmedical costs were considered. Incremental costs and effectiveness in terms of quality-adjusted life years (QALYs) were evaluated for a one-year timehorizon. The costs were expressed in 2016 Colombian pesos (1 USD = 3,051 Col$). Results In the vaginal delivery model, the average cost of care for a patient receiving prophylaxis with uterotonic agents was Col$ 347,750 with carbetocin and Col$ 262,491 with oxytocin,while theQALYs were 0.9980 and 0.9979, respectively. The incremental costeffectiveness ratio is above the cost-effectiveness threshold adopted by Colombia. In the model developed for cesarean section, the average cost of a patient receiving prophylaxis with uterotonics was Col$ 461,750 with carbetocin, and Col$ 481,866 with oxytocin, and the QALYs were 0.9959 and 0.9926, respectively. Carbetocin has lower cost and is more effective, with a saving of Col$ 94,887 per avoided hemorrhagic event. Conclusion In case of elective cesarean delivery, carbetocin is a dominant alternative in the prevention of PPH compared with oxytocin; however, it presents higher costs than oxytocin, with similar effectiveness, in cases of vaginal delivery. |
| first_indexed | 2024-12-24T01:47:56Z |
| format | Article |
| id | doaj.art-b78939f6673344d0b554e1d95089dba0 |
| institution | Directory Open Access Journal |
| issn | 0100-7203 |
| language | English |
| last_indexed | 2024-12-24T01:47:56Z |
| publishDate | 2018-05-01 |
| publisher | Federação Brasileira das Sociedades de Ginecologia e Obstetrícia |
| record_format | Article |
| series | Revista Brasileira de Ginecologia e Obstetrícia |
| spelling | doaj.art-b78939f6673344d0b554e1d95089dba02022-12-21T17:21:49ZengFederação Brasileira das Sociedades de Ginecologia e ObstetríciaRevista Brasileira de Ginecologia e Obstetrícia0100-72032018-05-0140524225010.1055/s-0038-1655747Cost-effectiveness of Carbetocin versus Oxytocin for Prevention of Postpartum Hemorrhage Resulting from Uterine Atony in Women at high-risk for bleeding in ColombiaYaneth Gil-RojasPieralessandro LasalviaFabián HernándezCamilo Castañeda-CardonaDiego RosselliAbstract Objective To assess the cost-effectiveness of carbetocin versus oxytocin for prevention of postpartum hemorrhage (PPH) due to uterine atony after vaginal delivery/ cesarean section in women with risk factors for bleeding. Methods A decision treewas developed for vaginal delivery andanother one for cesarean, in which a sequential analysis of the results was obtained with the use of carbetocin and oxytocin for prevention of PPH and related consequences. A third-party payer perspective was used; only directmedical costs were considered. Incremental costs and effectiveness in terms of quality-adjusted life years (QALYs) were evaluated for a one-year timehorizon. The costs were expressed in 2016 Colombian pesos (1 USD = 3,051 Col$). Results In the vaginal delivery model, the average cost of care for a patient receiving prophylaxis with uterotonic agents was Col$ 347,750 with carbetocin and Col$ 262,491 with oxytocin,while theQALYs were 0.9980 and 0.9979, respectively. The incremental costeffectiveness ratio is above the cost-effectiveness threshold adopted by Colombia. In the model developed for cesarean section, the average cost of a patient receiving prophylaxis with uterotonics was Col$ 461,750 with carbetocin, and Col$ 481,866 with oxytocin, and the QALYs were 0.9959 and 0.9926, respectively. Carbetocin has lower cost and is more effective, with a saving of Col$ 94,887 per avoided hemorrhagic event. Conclusion In case of elective cesarean delivery, carbetocin is a dominant alternative in the prevention of PPH compared with oxytocin; however, it presents higher costs than oxytocin, with similar effectiveness, in cases of vaginal delivery.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032018000500242&tlng=encost-effectivenesscarbetocinoxytocinprevention postpartum hemorrhagepregnancyhigh-risk |
| spellingShingle | Yaneth Gil-Rojas Pieralessandro Lasalvia Fabián Hernández Camilo Castañeda-Cardona Diego Rosselli Cost-effectiveness of Carbetocin versus Oxytocin for Prevention of Postpartum Hemorrhage Resulting from Uterine Atony in Women at high-risk for bleeding in Colombia Revista Brasileira de Ginecologia e Obstetrícia cost-effectiveness carbetocin oxytocin prevention postpartum hemorrhage pregnancy high-risk |
| title | Cost-effectiveness of Carbetocin versus Oxytocin for Prevention of Postpartum Hemorrhage Resulting from Uterine Atony in Women at high-risk for bleeding in Colombia |
| title_full | Cost-effectiveness of Carbetocin versus Oxytocin for Prevention of Postpartum Hemorrhage Resulting from Uterine Atony in Women at high-risk for bleeding in Colombia |
| title_fullStr | Cost-effectiveness of Carbetocin versus Oxytocin for Prevention of Postpartum Hemorrhage Resulting from Uterine Atony in Women at high-risk for bleeding in Colombia |
| title_full_unstemmed | Cost-effectiveness of Carbetocin versus Oxytocin for Prevention of Postpartum Hemorrhage Resulting from Uterine Atony in Women at high-risk for bleeding in Colombia |
| title_short | Cost-effectiveness of Carbetocin versus Oxytocin for Prevention of Postpartum Hemorrhage Resulting from Uterine Atony in Women at high-risk for bleeding in Colombia |
| title_sort | cost effectiveness of carbetocin versus oxytocin for prevention of postpartum hemorrhage resulting from uterine atony in women at high risk for bleeding in colombia |
| topic | cost-effectiveness carbetocin oxytocin prevention postpartum hemorrhage pregnancy high-risk |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032018000500242&tlng=en |
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