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Cost effectiveness analysis of carbetocin during cesarean section in a high volume maternity unit
Author(s) -
Voon Hian Yan,
Shafie Asrul A.,
Bujang Mohamad A.,
Suharjono Haris N.
Publication year - 2018
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.13486
Subject(s) - medicine , uterotonic , context (archaeology) , randomized controlled trial , obstetrics , oxytocin , surgery , biology , paleontology
Aim To evaluate the cost effectiveness of carbetocin compared to oxytocin when used as prophylaxis against post‐partum hemorrhage (PPH) during cesarean deliveries. Methods A systematic review of the literature was performed to identify randomized controlled trials that compared the use of carbetocin to oxytocin in the context of cesarean deliveries. Cost effectiveness analysis was then performed using secondary data from the perspective of a maternity unit within the Malaysian Ministry of Health, over a 24 h time period. Results Seven randomized controlled trials with over 2000 patients comparing carbetocin with oxytocin during cesarean section were identified. The use of carbetocin in our center, which has an average of 3000 cesarean deliveries annually, would have prevented 108 episodes of PPH, 104 episodes of transfusion and reduced the need for additional uterotonics in 455 patients. The incremental cost effectiveness ratio of carbetocin for averting an episode of PPH was US$278.70. Conclusion Reduction in retreatment, staffing requirements, transfusion and potential medication errors mitigates the higher index cost of carbetocin. From a pharmacoeconomic perspective, in the context of cesarean section, carbetocin was cost effective as prophylaxis against PPH. Ultimately, the relative value placed on the outcomes above and the individual unit's resources would influence the choice of uterotonic.