Medico Internista, Magister en Farmacoeconomia y Economia de la Salud, Medico Asistente del Hospital Nacional Edgardo Rebagliati Martins, Presidenta de ISPOR PERU, Lima, Peru. Medico Internista, Maestria en Epidemiologia Clinica, Medico Asistente del Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru. Director de la Unidad de Evaluacion de Tecnologias Sanitarias, Universidad Francisco de Vitoria, Madrid, Spain.
Journal of Comparative Effectiveness Research. 2017;7((1):):49-55
Postpartum hemorrhage is one of the main causes of maternal death. Oxytocin has traditionally been used to prevent postpartum hemorrhage. AIM: To compare oxytocin with carbetocin, a long-acting analog of oxytocin, for prevention of uterine hemorrhage after cesarean delivery. MATERIALS & METHODS Clinical data were retrieved from the 2012 Cochrane meta-analysis "Carbetocin for preventing postpartum hemorrhage". A decision tree was
constructed. The direct costs were those of medications from the Peruvian official price list (DIGEMID). Costs associated with additional oxytocic drugs, blood transfusions, postpartum hemorrhage kits and hysterectomy were obtained from Hospital Nacional Edgardo Rebagliati Martins. The perspective of the study was that of the payer. The time horizon for calculating quality-adjusted life years (QALYs) was 1 year (2015). RESULTS Patients who received carbetocin required fewer additional uterotonic agents, had fewer hemorrhages and received fewer blood transfusions. Therefore, the costs associated with these interventions were lower. The incremental cost-effectiveness ratio was S/. 49,918 per QALY gained, which is lower than the threshold we estimated for Peru. CONCLUSION Carbetocin is more cost-effective than oxytocin for prevention of uterine hemorrhage after cesarean delivery.