COST-EFFECTIVENESS IN LABOR INDUCTION WITH DINOPROSTONE OR VAGINAL MISOPROSTOL

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Author list: Javier CHF, Auxiliadora RB, Jaime PJ, Fernando CF, Jorge GH, Manuel HP
Publisher: Unknown
Publication year: 2012
Journal: Atencion Farmaceutica (1139-7357)
Volume number: 14
Issue number: 2
Start page: 81
End page: +
ISSN: 1139-7357
Languages: English-Great Britain (EN-GB)


Abstract

Objective: To determine which one of the two vaginal drugs, dinoprostone or misoprostol at their usual doses, has a better cost-effectiveness relation for cervical ripening before labor induction.Method: We used a decision tree that reflects the drug effects and their adverse events. The hospital's perspective was the one being used. The timeline was less than a year We did not consider any indirect or intangible costs, only direct healthcare costs of each alternative (2011 euros). We conducted a deterministic sensitivity analysis by varying widely the model's fundamental parameters around the basal state.Results: The attained incremental cost-effectiveness ratio was 0.07 (sic) per natural vaginal childbirth with dinoprostone versus misoprostol, both vaginally. The obtained effectiveness was 4,169.96 and 5,987.45 for vaginal labor with misoprostol and dinoprostone, respectively. The cost-effectiveness relationship for the controlled-release dinoprostone vaginal device was 0.51 (sic)/natural childbirth and for 50-mu g misoprostol tablets was 0.70 (sic)/natural childbirth. The deterministic sensitivity analysis shows the robustness of the obtained results.Conclusion: The treatment of pregnant women at term with unripe uterine neck with a single dose of 10-mg vaginal-release dinoprostone presents a more favorable cost-effectiveness relationship than two 25-mu g doses of vaginal misoprostol tablets, separated six hours between them.


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Last updated on 2019-23-08 at 11:15