Cost-Effectiveness of Erythropoietin in Traumatic Brain Injury : A Multinational Trial-Based Economic Analysis

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http://hdl.handle.net/10138/318418

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EPO-TBI Investigators , ANZICS Clinical Trials Grp , Knott , R J , Harris , A , Higgins , A , Pettilä , V & Skrifvars , M B 2019 , ' Cost-Effectiveness of Erythropoietin in Traumatic Brain Injury : A Multinational Trial-Based Economic Analysis ' , Journal of Neurotrauma , vol. 36 , no. 17 , pp. 2541-2548 . https://doi.org/10.1089/neu.2018.6229

Title: Cost-Effectiveness of Erythropoietin in Traumatic Brain Injury : A Multinational Trial-Based Economic Analysis
Author: EPO-TBI Investigators; ANZICS Clinical Trials Grp; Knott, Rachel J.; Harris, Anthony; Higgins, Alisa; Pettilä, Ville; Skrifvars, Markus B.
Contributor: University of Helsinki, HUS Perioperative, Intensive Care and Pain Medicine
University of Helsinki, University of Helsinki
Date: 2019-09-01
Language: eng
Number of pages: 8
Belongs to series: Journal of Neurotrauma
ISSN: 0897-7151
URI: http://hdl.handle.net/10138/318418
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.
Subject: cost-effectiveness
erythropoietin
multi-national trial
QALYs
traumatic brain injury
QUALITY-OF-LIFE
HEAD-INJURY
MODERATE
RESUSCITATION
CARE
3112 Neurosciences
3124 Neurology and psychiatry
3126 Surgery, anesthesiology, intensive care, radiology
3121 General medicine, internal medicine and other clinical medicine
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