Cost-utility analysis of an adjunctive recombinant activated factor VIIa for on-demand treatment of bleeding episodes in dengue haemorrhagic fever.

Abstract

The present study aimed to assess the cost-utility analysis of using an adjunctive recombinant activated factor VIIa (rFVIIa) in children for controlling life-threatening bleeding in dengue haemorrhagic fever (DHF)/dengue shock syndrome (DSS). We constructed a decision-tree model, comparing a standard care and the use of an additional adjuvant rFVIIa for controlling life-threatening bleeding in children with DHF/DSS. Cost and utility benefit were estimated from the societal perspective. The outcome measure was cost per quality-adjusted life years (QALYs). Overall, treatment with adjuvant rFVIIa gained QALYs, but the total cost was higher. The incremental cost-utility ratio for the introduction of adjuvant rFVIIa was $4241.27 per additional QALY. Sensitivity analyses showed the utility value assigned for calculation of QALY was the most sensitive parameter. We concluded that despite high cost, there is a role for rFVIIa in the treatment of life-threatening bleeding in patients with DHF/DSS.

• Authors: Cho Naing, Yong Poovorawan, Joon Wah Mak, Kyan Aung, Pirom Kamolratankul
• Journal: Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis (Blood Coagul Fibrinolysis) Vol. 26 Issue 4 Pg. 403-7 (Jun 2015) ISSN: 1473-5733 [Electronic] England
• PMID: 25692521 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Recombinant Proteins
• recombinant FVIIa
• Factor VIIa

Topics

• Adolescent
• Cost-Benefit Analysis
• Decision Trees
• Factor VIIa (economics, therapeutic use)
• Hemorrhage (complications, drug therapy, economics)
• Humans
• Quality-Adjusted Life Years
• Recombinant Proteins (economics, therapeutic use)
• Severe Dengue (complications, drug therapy, economics)