RESUMO
OBJECTIVE: To conduct a cost-utility analysis on recombinant human erythropoietin (rHuEPO) for treating anemic cancer patients induced by chemotherapy compared to blood transfusion alone under the Thai health care setting. MATERIALS AND METHODS: A health care provider's perspective was used to examine relevant costs and outcomes using the Markov model. Cost data were estimated based on the reference price set by the Ministry of Public Health. The effectiveness data were obtained from a systematic review of published literature. The results were presented in terms of incremental cost-effectiveness ratio (ICER) in Thai Baht per Quality Adjusted Life Years (QALYs) gained. A probabilistic sensitivity analysis method was performed. RESULTS: The ICERs of rHuEPO compared to blood transfusion alone were 3.7 and 2.7 millions Baht per QALY for patients with hemoglobin less than 8 g/dl and 8-9 g/dl, respectively. The rHuEPO required additional resources (more costly) with less benefit compared to blood transfusion for patients with hemoglobin 9-10 g/dl. CONCLUSIONS: The rHuEPO may be cost-ineffective for the treatment of anemia caused by chemotherapy in cancer patients in Thailand.
Assuntos
Anemia/induzido quimicamente , Antineoplásicos/efeitos adversos , Transfusão de Sangue , Análise Custo-Benefício , Eritropoetina/economia , Humanos , Cadeias de Markov , Neoplasias/complicações , Probabilidade , Anos de Vida Ajustados por Qualidade de Vida , TailândiaAssuntos
Humanos , Perda Sanguínea Cirúrgica , Complicações Intraoperatórias/terapia , Complicações Pós-Operatórias/terapia , Aprotinina/farmacologia , Transfusão de Sangue , Congresso , Estado Terminal , Eritropoetina/administração & dosagem , Eritropoetina , Eritropoetina/economia , Eritropoetina/farmacologia , Circulação Extracorpórea , Hemostasia Cirúrgica , Unidades de Terapia Intensiva/economia , Ferro/administração & dosagemRESUMO
It is presented the experience with 90 patients receiving Eritropoietin s.c. and oral iron who were in chronic haemodialysis. After basic laboratories, including iron kinetic, in all of them was stopped oral iron and started i.v. iron 60 mgs per week, but keeping the same eritropoietin doses. The results showed an increased haemoglobin level from 6.5 to 11 g/dl mean values and a decreased doses of eritropoietin between 25 to 50%. This represent an important elevation of haemoglobin levels at a significant low cost