Please use this identifier to cite or link to this item: http://repositorio.unicamp.br/jspui/handle/REPOSIP/197466
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
Villaça, 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.
Subject: Adolescent
Adult
Brazil
Child
Cohort Studies
Cost Of Illness
Factor Vii
Factor Viia
Female
Hemophilia A
Hemorrhage
Humans
Male
Prospective Studies
Recombinant Proteins
Retrospective Studies
Treatment Outcome
Citation: Haemophilia : The Official Journal Of The World Federation Of Hemophilia. v. 13, n. 5, p. 462-9, 2007-Sep.
Rights: fechado
Identifier DOI: 10.1111/j.1365-2516.2007.01522.x
Address: http://www.ncbi.nlm.nih.gov/pubmed/17880430
Date Issue: 2007
Appears in Collections:Unicamp - Artigos e Outros Documentos

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