Cost-effectiveness of uterine tamponade devices for the treatment of postpartum hemorrhage: A systematic review

SCOTT, NICK; OLADAPO, OLUFEMI T.; VOGEL, JOSHUA P.; WIDMER, MARIANA; WILSON, ALYCE N.; ALTHABE, FERNANDO

INTERNATIONAL JOURNAL OF GYNECOLOGY OBSTETRICS

ELSEVIER IRELAND LTD

Año: 2020 vol. 151 p. 333 - 340

0020-7292

Background: Uterine tamponade is widely promoted for treating refractory postpartum hemorrhage (PPH); however, its cost-effectiveness may vary depending on unit costs and setting. Objective: To review available data on cost-effectiveness of uterine tamponade devices when used for PPH treatment. Search strategy: PubMed and EMBASE were searched (1980 to January 2020), as well as the National Health Services Economic Evaluation database from inception (1995) to March 2015. Selection criteria: Eligible studies were any type of economic evaluation, or effectiveness studies that provided cost or economic data. Data collection and analysis: Two reviewers independently screened studies, extracted data, and assessed quality. Main results: Eleven studies using a range of devices (condom catheter, uterine suction devices, Bakri, Inpress, Ellavi) were identified. Cost of condom catheter devices or kits ranged from US$0.64 to US$6, whereas purpose-designed device costs were up to US$400. Two studies that took a health system perspective assessed the cost-effectiveness of using uterine balloon tamponade and suggested that it was highly cost-effective because of the low cost per disability-adjusted life-year averted, although both used effect estimates from case series. Conclusions: Evidence on the cost-effectiveness of uterine tamponade devices was limited and not generalizable. Rigorous economic evaluations based on updated effect estimates are needed.