Cost-effectiveness analysis of administering tranexamic acid to bleeding trauma patients using evidence from the CRASH-2 trial.

<h4>Objective</h4>To assess the cost effectiveness of giving tranexamic acid (TXA) to bleeding trauma patients in low, middle and high income settings.<h4>Methods</h4>The CRASH-2 trial showed that TXA administration reduces the risk of death in bleeding trauma patients with a...

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Autores principales:	Carla Guerriero, John Cairns, Pablo Perel, Haleema Shakur, Ian Roberts, CRASH 2 trial collaborators
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2011
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/d40b3b34b57a4f8da33f801f5a8cbe2e
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spelling	oai:doaj.org-article:d40b3b34b57a4f8da33f801f5a8cbe2e2021-12-02T20:11:46ZCost-effectiveness analysis of administering tranexamic acid to bleeding trauma patients using evidence from the CRASH-2 trial.1932-620310.1371/journal.pone.0018987https://doaj.org/article/d40b3b34b57a4f8da33f801f5a8cbe2e2011-05-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21559279/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective</h4>To assess the cost effectiveness of giving tranexamic acid (TXA) to bleeding trauma patients in low, middle and high income settings.<h4>Methods</h4>The CRASH-2 trial showed that TXA administration reduces the risk of death in bleeding trauma patients with a small but statistically significant increase in non-intensive care stay. A Markov model was used to assess the cost effectiveness of TXA in Tanzania, India and the United Kingdom (UK). The health outcome was the number of life years gained (LYs). Two costs were considered: the cost of administering TXA and the cost of additional days in hospital. Cost data were obtained from hospitals, World Health Organization (WHO) database and UK reference costs. Cost-effectiveness was measured in international dollars ($) per LY. Both deterministic and probabilistic sensitivity analyses were performed to test the robustness of the results to model assumptions.<h4>Findings</h4>Administering TXA to bleeding trauma patients within three hours of injury saved an estimated 372, 315 and 755 LYs per 1,000 trauma patients in Tanzania, India and the UK respectively. The cost of giving TXA to 1,000 patients was $17,483 in Tanzania, $19,550 in India and $30,830 in the UK. The incremental cost of giving TXA versus not giving TXA was $18,025 in Tanzania, $20,670 in India and $48,002 in the UK. The estimated incremental cost per LY gained of administering TXA is $48, $66 and $64 in Tanzania, India and the UK respectively.<h4>Conclusion</h4>Early administration of TXA to bleeding trauma patients is likely to be highly cost effective in low, middle and high income settings.<h4>Trial registration</h4>This paper uses data collected by the CRASH 2 trial: Controlled-Trials.com ISRCTN86750102, Clinicaltrials.govNCT00375258 and South African Clinical Trial Register DOH-27-0607-1919.Carla GuerrieroJohn CairnsPablo PerelHaleema ShakurIan RobertsCRASH 2 trial collaboratorsPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 6, Iss 5, p e18987 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Carla Guerriero John Cairns Pablo Perel Haleema Shakur Ian Roberts CRASH 2 trial collaborators Cost-effectiveness analysis of administering tranexamic acid to bleeding trauma patients using evidence from the CRASH-2 trial.
description	<h4>Objective</h4>To assess the cost effectiveness of giving tranexamic acid (TXA) to bleeding trauma patients in low, middle and high income settings.<h4>Methods</h4>The CRASH-2 trial showed that TXA administration reduces the risk of death in bleeding trauma patients with a small but statistically significant increase in non-intensive care stay. A Markov model was used to assess the cost effectiveness of TXA in Tanzania, India and the United Kingdom (UK). The health outcome was the number of life years gained (LYs). Two costs were considered: the cost of administering TXA and the cost of additional days in hospital. Cost data were obtained from hospitals, World Health Organization (WHO) database and UK reference costs. Cost-effectiveness was measured in international dollars ($) per LY. Both deterministic and probabilistic sensitivity analyses were performed to test the robustness of the results to model assumptions.<h4>Findings</h4>Administering TXA to bleeding trauma patients within three hours of injury saved an estimated 372, 315 and 755 LYs per 1,000 trauma patients in Tanzania, India and the UK respectively. The cost of giving TXA to 1,000 patients was $17,483 in Tanzania, $19,550 in India and $30,830 in the UK. The incremental cost of giving TXA versus not giving TXA was $18,025 in Tanzania, $20,670 in India and $48,002 in the UK. The estimated incremental cost per LY gained of administering TXA is $48, $66 and $64 in Tanzania, India and the UK respectively.<h4>Conclusion</h4>Early administration of TXA to bleeding trauma patients is likely to be highly cost effective in low, middle and high income settings.<h4>Trial registration</h4>This paper uses data collected by the CRASH 2 trial: Controlled-Trials.com ISRCTN86750102, Clinicaltrials.govNCT00375258 and South African Clinical Trial Register DOH-27-0607-1919.
format	article
author	Carla Guerriero John Cairns Pablo Perel Haleema Shakur Ian Roberts CRASH 2 trial collaborators
author_facet	Carla Guerriero John Cairns Pablo Perel Haleema Shakur Ian Roberts CRASH 2 trial collaborators
author_sort	Carla Guerriero
title	Cost-effectiveness analysis of administering tranexamic acid to bleeding trauma patients using evidence from the CRASH-2 trial.
title_short	Cost-effectiveness analysis of administering tranexamic acid to bleeding trauma patients using evidence from the CRASH-2 trial.
title_full	Cost-effectiveness analysis of administering tranexamic acid to bleeding trauma patients using evidence from the CRASH-2 trial.
title_fullStr	Cost-effectiveness analysis of administering tranexamic acid to bleeding trauma patients using evidence from the CRASH-2 trial.
title_full_unstemmed	Cost-effectiveness analysis of administering tranexamic acid to bleeding trauma patients using evidence from the CRASH-2 trial.
title_sort	cost-effectiveness analysis of administering tranexamic acid to bleeding trauma patients using evidence from the crash-2 trial.
publisher	Public Library of Science (PLoS)
publishDate	2011
url	https://doaj.org/article/d40b3b34b57a4f8da33f801f5a8cbe2e
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Cost-effectiveness analysis of administering tranexamic acid to bleeding trauma patients using evidence from the CRASH-2 trial.

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