Abstract:
:The EPO-TBI multi-national randomized controlled trial found that erythropoietin (EPO), when compared to placebo, did not affect 6-month neurological outcome, but reduced illness severity-adjusted mortality in patients with traumatic brain injury (TBI), making the cost-effectiveness of EPO in TBI uncertain. The current study uses patient-level data from the EPO-TBI trial to evaluate the cost-effectiveness of EPO in patients with moderate or severe TBI from the healthcare payers' perspective. We addressed the issue of transferability in multi-national trials by estimating costs and effects for specific geographical regions of the study (Australia/New Zealand, Europe, and Saudi Arabia). Unadjusted mean quality-adjusted life-years (QALYs; 95% confidence interval [CI]) at 6 months were 0.027 (0.020-0.034; p < 0.001) higher in the EPO group, with an adjusted QALY increment of 0.014 (0.000-0.028; p = 0.04). Mean unadjusted costs (95% CI) were $US5668 (-9191 to -2144; p = 0.002) lower in the treatment group; controlling for baseline IMPACT-TBI score and regional heterogeneity reduced this difference to $2377 (-12,446 to 7693; p = 0.64). For a willingness-to-pay threshold of $US50,000 per QALY, 71.8% of replications were considered cost-effective. Therefore, we did not find evidence that EPO was significantly cost-effective in the treatment of moderate or severe TBI at 6-month follow-up.
journal_name
J Neurotraumajournal_title
Journal of neurotraumaauthors
Knott RJ,Harris A,Higgins A,Nichol A,French C,Little L,Haddad S,Presneill J,Arabi Y,Bailey M,Cooper DJ,Duranteau J,Huet O,Mak A,McArthur C,Pettilä V,Skrifvars MB,Vallance S,Varma D,Wills J,Bellomo Rdoi
10.1089/neu.2018.6229subject
Has Abstractpub_date
2019-09-01 00:00:00pages
2541-2548issue
17eissn
0897-7151issn
1557-9042journal_volume
36pub_type
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