The cost-effectiveness of tranexamic acid for treatment of postpartum hemorrhage: A systematic review

被引:10
|
作者
Aziz, Samia [1 ,2 ]
Rossiter, Shania [1 ,2 ]
Homer, Caroline S. E. [1 ]
Wilson, Alyce N. [1 ,3 ]
Comrie-Thomson, Liz [1 ,4 ,5 ]
Scott, Nick [1 ]
Vogel, Joshua P. [1 ,3 ]
机构
[1] Burnet Inst, Maternal Child & Adolescent Hlth Program, 85 Commercial Rd, Melbourne, Vic 3004, Australia
[2] Univ Melbourne, Sch Populat & Global Hlth, Melbourne, Vic, Australia
[3] Univ Melbourne, Melbourne Sch Populat & Global Hlth, Nossal Inst Global Hlth, Melbourne, Vic, Australia
[4] Monash Univ, Sch Publ Hlth & Prevent Med, Melbourne, Vic, Australia
[5] Univ Ghent, Fac Med & Hlth Sci, Ghent, Belgium
关键词
cost effectiveness; postpartum hemorrhage; tranexamic acid; WOMAN; WOMEN;
D O I
10.1002/ijgo.13654
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Background Postpartum hemorrhage (PPH) is responsible for nearly one quarter of maternal deaths. A 2017 multicountry trial found that incorporating tranexamic acid (TXA) into the PPH management package was effective in reducing maternal death due to bleeding. Objective To systematically review studies assessing the cost-effectiveness of tranexamic acid for PPH treatment. Search strategy Nine databases were searched using variations of keywords 'tranexamic acid', 'postpartum hemorrhage' and 'cost effectiveness'. Selection criteria Eligible studies were any type of economic or effectiveness evaluation studies on tranexamic acid for treating women with PPH. Data collection and analysis Two reviewers independently screened citations and extracted data on cost effectiveness measures. Quality was assessed using the Consensus on Health Economic Criteria list. Main results Four studies were included, of which two were abstracts. Three studies concluded that early administration of TXA was cost-saving or cost-effective. One abstract reported TXA was not cost-effective in the USA unless the probability of death due to hemorrhage is higher. Conclusion Available evidence (four studies in three countries) suggests that this life-saving intervention may be below willingness to pay thresholds (cost-effective) or cost saving. Further studies conducted in different populations and settings are needed to inform health policy decision-making to reduce PPH-associated morbidity and mortality.
引用
收藏
页码:331 / 344
页数:14
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