Author(s)
Pacocha K1, Pieniazek I1, Stelmachowski J1, Walczak J1, Bierut A2, Sajdak S3, Wilczak M4, Jaworowski A5, Rokita W6, Młodawski J6, Baev OR7, Bila J8, Pitko V9, Zhemela O10, Chorna O11, Lohinova O12
1Arcana Institute a Certara Company, Cracow, Poland, 2Ferring Pharmaceuticals Poland, Warszawa, Poland, 3Clinic of Surgical Gynecology, University of Medical Sciences, Poznań, Poland, Poznań, Poland, 4Department of Maternal and Child Health , Gynaecology and Obstetrics Hospital of the Medical University in Poznan, Poland, Poznan, Poland, 5Clinical Department of Obstetrics and Perinatology The University Hospital in Cracow, Poland, Cracow, Poland, 6Clinic of Gynecology and Obstetrics, Provincial Integrated Hospital in Kielce, Poland, Kielce, Poland, 7National Medical Research center obstetrics, gynecology and perinatology the name of Academician V.I. Kulakov, MOSCOW, Russian Federation, 8Clinic of Obstetrics and Gynecology, Clinical Center of Serbia, Belgrade, Serbia, Belgrade, Serbia, 9The Government hospital Obstetrics, Gynecology and Reproductology Kcharkiv, Kcharkiv, Ukraine, 10Lviv нац. Мед университет, Lviv, Ukraine, 11The Obstetrics and Gynecology Department #2 KNMU, Kiev, Ukraine, 12Medical Academy Kcharkiv, Kcharkiv, Ukraine
OBJECTIVES: The aim of the project was to develop a user-friendly decision model to assess the savings and health benefits of induction of labour (IOL) when Dinoprostone Vaginal Delivery System (DVDS) is used instead of alternative technologies in local European practice. The model allowed to reveal changes in time consumed by hospital staff due to DVDS administration, demonstrate the safety profile of DVDS versus alternatives and calculate total cost of IOL for local settings. METHODS: The model refers to clinical and safety aspects of technologies used in current practice, including time to vaginal delivery, time to active labour, occurrence of cesarean delivery, instrumental vaginal delivery and adverse events. Efficacy and safety data was retrieved following a systematic literature review conducted in medical databases. Cost and resource use data came from local clinical practice as local data sources consisted of hospitals and medical centers. Data was collected from the hospital perspective via a dedicated questionnaire. RESULTS: A systematic review and data synthesis were performed for all comparators used in IOL indicated by local experts and included: oxytocin; balloon catheter; dinoprostone: cervical gel, vaginal gel, vaginal tablets; misoprostol: vaginal tablets, vaginal insert; amniotomy; mifepristone and hygroscopic cervical dilators. Preliminary results for Russian conditions indicated that per 100 patients, the number of instrumental vaginal and Cesarean deliveries avoided by replacing current practice interventions with DVDS amounted to 1.9 and 6.2, respectively. DVDS is cost-saving for the following categories of costs: inpatient stay, medical staff wages and additional oxytocin use as it generates additional expenditures in the treatment of adverse events. CONCLUSIONS: The cost-consequences model used to assess profitability of DVDS joins real life data from local practice with experimental data retrieved from RCTs. The model is a transparent tool that provides information on treatment standards and costs of IOL in CEE countries.
Conference/Value in Health Info
2018-11, ISPOR Europe 2018, Barcelona, Spain
Value in Health, Vol. 21, S3 (October 2018)
Code
PMD53
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies, Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Reproductive and Sexual Health
