PharmacoEconomics

, Volume 18, Issue 2, pp 161–171

Cost Effectiveness of Epoetin-α to Augment Preoperative Autologous Blood Donation in Elective Cardiac Surgery

  • Douglas Coyle
  • Karen M. Lee
  • Dean A. Fergusson
  • Andreas Laupacis
Original Research Article

DOI: 10.2165/00019053-200018020-00006

Cite this article as:
Coyle, D., Lee, K.M., Fergusson, D.A. et al. Pharmacoeconomics (2000) 18: 161. doi:10.2165/00019053-200018020-00006

Abstract

Objective: The objective of this study was to assess the cost effectiveness of using epoetin-α (erythropoietin) to augment preoperative autologous donation (PAD) of blood prior to elective cardiac surgery.

Design and setting: We designed a decision-analytic model incorporating the risk of receiving allogeneic blood, the costs of blood products, the likelihood of developing transfusion-related diseases, the costs of transfusion-related diseases and their impact on life expectancy, and the effect of epoetin-α on the probability of transfusion.

Interventions: The efficacy of epoetin-α was derived from data from a meta-analysis of published randomised trials comparing the use of epoetin-α to augment PAD with the use of PAD alone. Estimates for the other parameters were obtained by a systematic review of the literature.

Main outcome measures and results: The use of epoetin-α reduced the proportion of patients receiving allogeneic transfusions by 60% (from 31.6 to 12.7%). However, this led to only a modest benefit of 0.000035 life years gained per patient and an incremental cost per life year gained of $Can44.6 million (1998 Canadian dollars). A detailed sensitivity analysis confirmed that the cost-effectiveness ratio was larger than that which is generally considered acceptable.

Conclusions: Our study indicates that the use of epoetin-α to reduce perioperative allogeneic transfusions in cardiac surgery is not cost effective.

Copyright information

© Adis International Limited 2000

Authors and Affiliations

  • Douglas Coyle
    • 1
    • 2
  • Karen M. Lee
    • 3
  • Dean A. Fergusson
    • 1
  • Andreas Laupacis
    • 1
    • 2
  1. 1.Clinical Epidemiology Unit, Loeb Health Research InstituteOttawa HospitalOttawaCanada
  2. 2.Departments of Medicine and Epidemiology and Community MedicineUniversity of OttawaOttawaCanada
  3. 3.Health Priorities Research GroupUniversity of California — IrvineIrvineUSA

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