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Cost‐effectiveness of two interventions for the prevention of postpartum hemorrhage in Senegal
Author(s) -
Vlassoff Michael,
Diallo Alioune,
Philbin Jesse,
Kost Kathryn,
Bankole Akin
Publication year - 2016
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2015.10.015
Subject(s) - medicine , misoprostol , cohort , psychological intervention , cost effectiveness , obstetrics , referral , randomized controlled trial , oxytocin , emergency medicine , pregnancy , surgery , family medicine , nursing , abortion , risk analysis (engineering) , genetics , biology
Objective To compare, at the community level, the cost‐effectiveness of oxytocin and misoprostol for the prevention of postpartum hemorrhage (PPH). Methods The present cost‐effectiveness study used data collected during a randomized trial that compared the prophylactic effectiveness of misoprostol and oxytocin for the prevention of PPH in a rural setting in Senegal between June 6 and September 21 2013. The two interventions were compared, with referral to a higher level facility owing to PPH being the outcome measure. The costs and effects were calculated for two hypothetical cohorts of patients delivering during a 1‐year period, with each cohort receiving one intervention. A comparison with a third hypothetical cohort receiving the current standard of care was included. A sensitivity analysis was performed to estimate the impact of variations in model assumptions. Results The cost per PPH referral averted was US$ 38.96 for misoprostol and US$ 119.15 for oxytocin. In all the scenarios modeled the misoprostol intervention dominated, except in the worst‐case scenario, where the oxytocin intervention demonstrated slightly better cost‐effectiveness. Conclusion The use of misoprostol for PPH prophylaxis could be cost effective and improve maternal outcomes in low‐income settings.