Abstract
| Original language | English |
|---|---|
| Number of pages | 8 |
| Journal | Journal of Neurotrauma |
| DOIs | |
| Publication status | Accepted/In press - 2019 |
Cite this
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Cost-effectiveness of erythropoietin in traumatic brain injury : a multinational trial-based economic analysis. / Knott, Rachel J.; Harris, Anthony; Higgins, Alisa; Nichol, Alistair; French, Craig; Little, Lorraine; Haddad, Samir; Presneill, Jeffrey; Arabi, Yaseen; Bailey, Michael; Cooper, D. James; Duranteau, Jacques; Huet, Olivier; Mak, Anne; McArthur, Colin; Pettila, Ville; Skrifvars, Markus; Vallance, Shirley; Varma, Dinesh; Wills, Judy; Bellomo, Rinaldo; For the EPO-TBI investigators and the ANZICS Clinical Trials Group.
In: Journal of Neurotrauma, 2019.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - Cost-effectiveness of erythropoietin in traumatic brain injury
T2 - a multinational trial-based economic analysis
AU - Knott, Rachel J.
AU - Harris, Anthony
AU - Higgins, Alisa
AU - Nichol, Alistair
AU - French, Craig
AU - Little, Lorraine
AU - Haddad, Samir
AU - Presneill, Jeffrey
AU - Arabi, Yaseen
AU - Bailey, Michael
AU - Cooper, D. James
AU - Duranteau, Jacques
AU - Huet, Olivier
AU - Mak, Anne
AU - McArthur, Colin
AU - Pettila, Ville
AU - Skrifvars, Markus
AU - Vallance, Shirley
AU - Varma, Dinesh
AU - Wills, Judy
AU - Bellomo, Rinaldo
AU - For the EPO-TBI investigators and the ANZICS Clinical Trials Group
PY - 2019
Y1 - 2019
N2 - 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.
AB - 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.
U2 - 10.1089/neu.2018.6229
DO - 10.1089/neu.2018.6229
M3 - Article
JO - Journal of Neurotrauma
JF - Journal of Neurotrauma
SN - 0897-7151
ER -