An economic evaluation of tranexamic acid to prevent postpartum haemorrhage in women with vaginal delivery: the randomised controlled TRAAP trial.
BJOG
; 128(1): 114-120, 2021 01.
Article
in En
| MEDLINE
| ID: mdl-32770781
ABSTRACT
OBJECTIVE:
To estimate the cost-effectiveness of tranexamic acid (TXA) use to prevent postpartum haemorrhage.DESIGN:
A trial-based economic evaluation.SETTING:
Fifteen French university maternity hospitals. POPULATION Women enrolled in the TRAAP randomised controlled trial comparing TXA versus placebo in women with vaginal delivery. TRAAP failed to show a reduction in postpartum haemorrhage of at least 500 ml in the intervention arm but evidenced significant lower rates of secondary outcomes related to blood loss. METHODS & MAIN OUTCOMEMEASURES:
We estimated direct medical costs from within-trial hospital resources collected prospectively from the study report form. All resources were costed at their value to the hospital. We estimated incremental cost per incremental haemorrhage averted.RESULTS:
Among the 4079 women in the TRAAP trial, data necessary to calculate costs were available for 3836 (94.0%). The average total costs in the TXA and control groups were 2278 ± 388 and 2288 ± 409 per woman, respectively (P = 0.79). In women with postpartum haemorrhage of at least 500 ml (trial primary endpoint), costs were 2359 ± 354 and 2409 ± 525 (P = 0.14); for provider-assessed clinically significant postpartum haemorrhage and postpartum haemorrhage of at least 1000 ml, costs were respectively 2316 ± 347 versus 2381 ± 521 (P = 0.22) and 2321 ± 318 versus 2411 ± 590 (P = 0.35) in the tranexamic and placebo groups, respectively. The probabilistic sensitivity analysis showed that the use of TXA had a 65-73% probability of saving costs and improving outcome.CONCLUSIONS:
Our findings support the use of TXA, as both bleeding events and cost may be reduced three out of four times. TWEETABLE ABSTRACT Tranexamic acid at vaginal delivery reduces both costs and bleeding events 3 times out of 4.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Tranexamic Acid
/
Delivery, Obstetric
/
Postpartum Hemorrhage
/
Antifibrinolytic Agents
Type of study:
Clinical_trials
/
Health_economic_evaluation
Limits:
Adult
/
Female
/
Humans
/
Pregnancy
Country/Region as subject:
Europa
Language:
En
Journal:
BJOG
Journal subject:
GINECOLOGIA
/
OBSTETRICIA
Year:
2021
Document type:
Article
Affiliation country: