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Title: | Cost-Effectiveness of Erythropoietin in Traumatic Brain Injury: A Multinational Trial-Based Economic Analysis. | Austin Authors: | Knott, Rachel J;Harris, Anthony;Higgins, Alisa;Nichol, Alistair;French, Craig;Little, Lorraine;Haddad, Samir;Presneill, Jeffrey;Arabi, Yaseen;Bailey, Michael;Cooper, D James;Duranteau, Jacques;Huet, Olivier;Mak, Anne;McArthur, Colin;Pettilä, Ville;Skrifvars, Markus B;Vallance, Shirley;Varma, Dinesh;Wills, Judy;Bellomo, Rinaldo | Affiliation: | Centre for Health Economics, Monash Business School, Monash University, Melbourne, Victoria, Australia King Saud Bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center Riyadh, Kingdom of Saudi Arabia University of Queensland and Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia University College Dublin-Clinical Research Centre, St Vincent's University Hospital, Dublin, Ireland Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia Western Health, Melbourne, Victoria, Australia University of Melbourne, Melbourne, Victoria, Australia Austin Health The Alfred, Melbourne, Victoria, Australia University of Helsinki and Helsinki University Hospital, Helsinki, Finland Auckland City Hospital, Auckland, New Zealand Department of Anaesthesiology and Intensive Care Medicine, CHU La Cavale Blanche, Brest, France Département d'Anesthésie-Réanimation, Hôpital de Bicêtre, Assistance Publique des Hopitaux de Paris, Hôpitaux Universitaires Paris-Sud, Université Paris-Sud, Paris, France University of Helsinki and Helsinki University Hospital, Helsinki, Finland |
Issue Date: | Sep-2019 | Date: | 2019-05-23 | Publication information: | Journal of Neurotrauma 2019; 36(17): 2541-2548 | Abstract: | The EPO-TBI multi-national randomized controlled trial found that erythropoietin (EPO), when compared to placebo, did not affect 6-month neurological outcome, but reduced illness severity-adjusted mortality in patients with traumatic brain injury (TBI), making the cost-effectiveness of EPO in TBI uncertain. The current study uses patient-level data from the EPO-TBI trial to evaluate the cost-effectiveness of EPO in patients with moderate or severe TBI from the healthcare payers' perspective. We addressed the issue of transferability in multi-national trials by estimating costs and effects for specific geographical regions of the study (Australia/New Zealand, Europe, and Saudi Arabia). Unadjusted mean quality-adjusted life-years (QALYs; 95% confidence interval [CI]) at 6 months were 0.027 (0.020-0.034; p < 0.001) higher in the EPO group, with an adjusted QALY increment of 0.014 (0.000-0.028; p = 0.04). Mean unadjusted costs (95% CI) were $US5668 (-9191 to -2144; p = 0.002) lower in the treatment group; controlling for baseline IMPACT-TBI score and regional heterogeneity reduced this difference to $2377 (-12,446 to 7693; p = 0.64). For a willingness-to-pay threshold of $US50,000 per QALY, 71.8% of replications were considered cost-effective. Therefore, we did not find evidence that EPO was significantly cost-effective in the treatment of moderate or severe TBI at 6-month follow-up. | URI: | https://ahro.austin.org.au/austinjspui/handle/1/25242 | DOI: | 10.1089/neu.2018.6229 | Journal: | Journal of Neurotrauma | PubMed URL: | 30907230 | Type: | Journal Article | Subjects: | QALYs cost-effectiveness erythropoietin multi-national trial traumatic brain injury |
Appears in Collections: | Journal articles |
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