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Type: Artigo de periódico
Title: A Cost Evaluation Of Treatment Alternatives For Mild-to-moderate Bleeding Episodes In Patients With Haemophilia And Inhibitors In Brazil
Author: Ozelo M.C.
Villaca P.R.
De Almeida J.O.S.C.
Bueno T.M.F.
De Miranda P.A.P.
Hart W.M.
Karamalis M.
Abstract: The first-line treatment for mild-to-moderate bleeding episodes in patients with haemophilia and inhibitors in Brazil is currently activated prothrombin complex concentrate (aPCC), with recombinant activated factor VII (rFVIIa) used as second-line therapy or as a last resort. The aim of this study was to determine the cost and effectiveness of these treatments from the perspective of the Brazilian National Health Service. A decision analysis model was constructed to assess total direct medical costs (including drug costs, costs of outpatient or inpatient care, ambulance transportation and cost of concomitant medications) of first-line treatment with aPCC or rFVIIa. Clinical outcome and resource utilization data were obtained both retrospectively and prospectively and validated by the consensus of an expert panel of Brazilian haematologists. A total of 103 bleeds in 25 patients were included in the analysis. rFVIIa resolved bleeds more quickly (4.4 h) than aPCC (62.6 h) and was more effective (100% vs. 56.7% respectively). Mean total direct medical costs (from initiation to cessation of bleed) were estimated to be US$13 500 (aPCC) and US$7590 (rFVIIa). Extensive sensitivity analyses confirmed the cost-effectiveness of rFVIIa. Compared with aPCC, rFVIIa was more effective and less expensive when used as first-line treatment for mild-to-moderate bleeding episodes in patients with haemophilia and inhibitors in Brazil. rFVIIa should be considered a first-line treatment for the management of these patients. © 2007 The Authors Journal compilation 2007 Blackwell Publishing Ltd.
Rights: fechado
Identifier DOI: 10.1111/j.1365-2516.2007.01522.x
Date Issue: 2007
Appears in Collections:Unicamp - Artigos e Outros Documentos

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