Cost effectiveness of epoetin-alpha to augment preoperative autologous blood donation in elective cardiac surgery.

Abstract:

OBJECTIVE:The objective of this study was to assess the cost effectiveness of using epoetin-alpha (erythropoietin) to augment preoperative autologous donation (PAD) of blood prior to elective cardiac surgery. DESIGN AND SETTING:We designed a decision-analytic model incorporating the risk of receiving allogeneic blood, the costs of blood products, the likelihood of developing transfusion-related diseases, the costs of transfusion-related diseases and their impact on life expectancy, and the effect of epoetin-alpha on the probability of transfusion. INTERVENTIONS:The efficacy of epoetin-alpha was derived from data from a meta-analysis of published randomised trials comparing the use of epoetin-alpha to augment PAD with the use of PAD alone. Estimates for the other parameters were obtained by a systematic review of the literature. MAIN OUTCOME MEASURES AND RESULTS:The use of epoetin-alpha reduced the proportion of patients receiving allogeneic transfusions by 60% (from 31.6 to 12.7%). However, this led to only a modest benefit of 0.000035 life years gained per patient and an incremental cost per life year gained of $Can44.6 million (1998 Canadian dollars). A detailed sensitivity analysis confirmed that the cost-effectiveness ratio was larger than that which is generally considered acceptable. CONCLUSIONS:Our study indicates that the use of epoetin-alpha to reduce perioperative allogeneic transfusions in cardiac surgery is not cost effective.

journal_name

Pharmacoeconomics

journal_title

PharmacoEconomics

authors

Coyle D,Lee KM,Fergusson DA,Laupacis A

doi

10.2165/00019053-200018020-00006

subject

Has Abstract

pub_date

2000-08-01 00:00:00

pages

161-71

issue

2

eissn

1170-7690

issn

1179-2027

journal_volume

18

pub_type

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