Coyle D, Lee K, Fergusson D, Laupacis A; International Society of Technology Assessment in Health Care. Meeting.
Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 1998; 14: 58.
Clinical Epidemiology Unit, Loeb Research Institute, Ottawa Civic Hospital and the Department of Medicine, University of Ottawa, Ottawa, Canada.
OBJECTIVE: To assess the cost-effectiveness of erythropoietin (EPO) to reduce patient's exposure to allogeneic blood products during orthopedic surgery. METHOD: A decision analytic model was designed incorporating the risk of receiving allogeneic blood, the costs of blood products, the likelihood of developing transfusion related disease, the costs of transfusion related diseases on patient morbidity and mortality. Estimates for the above were obtained by a systematic review of the literature. The cost-effectiveness of the use of EPO alone and EPO to augment preoperative autologous donation (PAD) was assessed by incorporating the effect of treatment on the risks of receiving allogeneic transfusions as assessed by a meta analysis of the available literature. RESULTS: EPO leads to a significant reduction in the proportion of patients receiving allogeneic transfusion: a relative reduction of 51% for EPO alone and 37% for EPO to augment PAD versus PAD alone. Life expectancy was increased by 0.000029 years for EPO alone and by 0.000007 years for EPO to augment PAD. The incremental cost per life year gained was $55 million for EPO alone and $296 million for EPO to augment PAD. The results were robust to an extensive range of sensitivity analysis. CONCLUSIONS: The use of EPO prior to surgery significantly reduces the proportion of patients receiving allogeneic blood. However, EPO leads to only modest increases in life expectancy due to the low risks of transfusion related diseases and reduction in the frequency of perioperative transfusions. Thus, the use of EPO, in this context, can not be considered cost-effective under conventional criteria.
Publication Types:
Keywords:
- Blood Transfusion
- Cost-Benefit Analysis
- Costs and Cost Analysis
- Erythropoietin
- Erythropoietin, Recombinant
- Humans
- Meta-Analysis
- Orthopedics
- Protein Binding
- Sensitivity and Specificity
- blood
- economics
- hsrmtgs
Other ID:
UI: 102234702
From Meeting Abstracts