Cost-effectiveness of two interventions for the prevention of postpartum hemorrhage in Senegal

• Published in: International journal of gynecology and obstetrics Vol. 133; no. 3; pp. 307 - 311
• Main Authors: Vlassoff, Michael, Diallo, Alioune, Philbin, Jesse, Kost, Kathryn, Bankole, Akin
• Format: Journal Article
• Language: English
• Published: United States Elsevier Ireland Ltd 01.06.2016
• Subjects: CEA; Cost-Benefit Analysis; Cost-effectiveness; Female; Humans; Misoprostol; Misoprostol - economics; Misoprostol - therapeutic use; Obstetrics and Gynecology; Oxytocics - economics; Oxytocics - therapeutic use; Oxytocin; Oxytocin - economics; Oxytocin - therapeutic use; Postpartum hemorrhage; Postpartum Hemorrhage - prevention & control; PPH; Pregnancy; Referral and Consultation; Senegal; Oxytocin; Senegal; Postpartum hemorrhage; PPH; Cost-effectiveness; Misoprostol; CEA
• ISSN: 0020-7292; 1879-3479
• DOI: 10.1016/j.ijgo.2015.10.015

Abstract Objective To compare, at the community level, the cost-effectiveness of oxytocin and misoprostol for the prevention of postpartum hemorrhage (PPH). Methods The present cost-effectiveness study used data collected during a randomized trial that compared the prophylactic effectiveness of misoprostol and oxytocin for the prevention of PPH in a rural setting in Senegal between June 6 and September 21 2013. The two interventions were compared, with referral to a higher level facility owing to PPH being the outcome measure. The costs and effects were calculated for two hypothetical cohorts of patients delivering during a 1-year period, with each cohort receiving one intervention. A comparison with a third hypothetical cohort receiving the current standard of care was included. A sensitivity analysis was performed to estimate the impact of variations in model assumptions. Results The cost per PPH referral averted was US$ 38.96 for misoprostol and US$ 119.15 for oxytocin. In all the scenarios modeled the misoprostol intervention dominated, except in the worst-case scenario, where the oxytocin intervention demonstrated slightly better cost-effectiveness. Conclusion The use of misoprostol for PPH prophylaxis could be cost effective and improve maternal outcomes in low-income settings.