Economic analysis of erythropoietin use in surgery
Coyle D, Lee K, Laupacis A, Fergusson D
Record ID 31999008417
English
Authors' objectives:
This report aims to assess the cost-effectiveness of erythropoietin (EPO) in surgery.
Authors' recommendations:
The benefit of EPO in reducing allogeneic blood transfusions was estimated by a systematic review of published studies. Without pre-donation, EPO reduced the proportion of orthopedic surgery patients receiving allogeneic transfusion by 51% (from 48% to 24%). With predonation, EPO reduced the proportion of patients receiving allogeneic transfusions by 37% (from 17% to 11%) in orthopedic surgery and by 60% (from 32% to 13%) in cardiac surgery.
The decision analysis incorporated the reduction in allogeneic blood transfusions with the costs and effects associated with treatment and transfusion, and with transfusion related disease. In the base case scenario, EPO led to only modest incremental benefit compared to no intervention for orthopedic surgery (0.000029 life years gained). As an augmentation to PAD, EPO led to modest benefits in both cardiac (0.000043 life years) and orthopedic (0.000007 life years) surgery. For EPO compared to no intervention in orthopedic surgery, the incremental cost per life year gained was 55 million USD. For EPO to augment PAD, the incremental cost per life year gained was 296 million USD for orthopedic surgery and 35 million USD for cardiac surgery.
Detailed sensitivity analysis was conducted varying the rates of transfusion in the control group, the risks of transfusion related illnesses, and the quality of life and life expectancy with transfusion related illnesses. However, the cost-effectiveness ratio did not fall to a level generally considered acceptable. The conclusion of this report is that the use of EPO in reducing perioperative allogeneic transfusions is not cost-effective by conventional criteria.
Authors' methods:
Economic evaluation
Details
Project Status:
Completed
URL for project:
https://www.ccohta.ca/
Year Published:
1998
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
Canada
MeSH Terms
- Blood Transfusion
- Cardiac Surgical Procedures
- Costs and Cost Analysis
- Erythropoietin
- General Surgery
- Orthopedics
Contact
Organisation Name:
Canadian Coordinating Office for Health Technology Assessment
Contact Address:
600-865 Carling Avenue, Ottawa, ON K1S 5S8 Canada. Tel: +1 613 226 2553, Fax: +1 613 226 5392;
Contact Name:
requests@cadth.ca
Contact Email:
requests@cadth.ca
Copyright:
Canadian Coordinating Office for Health Technology Assessment
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.