IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0164718.html
   My bibliography  Save this article

Using Misoprostol for Primary versus Secondary Prevention of Postpartum Haemorrhage – Do Costs Matter?

Author

Listed:
  • Susmita Chatterjee
  • Anupam Sarkar
  • Krishna D Rao

Abstract

Background: Postpartum heammorrhage (PPH), defined as blood loss greater than or equal to 500 ml within 24 hours after birth, is the leading cause of maternal deaths globally and in India. Misoprostol is an important option for PPH management in setting where oxytocin (the gold standard for PPH prevention and treatment) in not available or not feasible to use. For the substantial number of deliveries which take place at home or at lower level heatlh facilities in India, misoprostol pills can be adminstered to prevent PPH. The standard approach using misoprostol is to administer it prophylactically as primary prevention (600 mcg). An alternative strategy could be to administer misoprostol only to those who are at high risk of having PPH i.e. as secondary prevention. Methods: This study reports on the relative cost per person of a strategy involving primary versus secondary prevention of PPH using misoprostol. It is based on a randomized cluster trial that was conducted in Bijapur district in Karnataka, India between December 2011 and March 2014 among pregnant women to compare two community-level strategies for the prevention of PPH: primary and secondary. The analysis was conducted from the government perspective using an ingredient approach. Results: The cluster trial showed that there were no significant differences in clinical outcomes between the two study arms. However, the results of the cost analysis show that there is a difference of INR 6 (US$ 0.1) per birth for implementing the strategies primary versus secondary prevention. In India where 14.9 million births take place at sub-centres and at home, this additional cost of INR 6 per birth translates to an additional cost of INR 94 (US$ 1.6) million to the government to implement the primary prevention compared to the secondary prevention strategy. Conclusion: As clinical outcomes did not differ significantly between the two arms in the trial, taking into account the difference in costs and potential issues with sustainability, secondary prevention might be a more strategic option.

Suggested Citation

  • Susmita Chatterjee & Anupam Sarkar & Krishna D Rao, 2016. "Using Misoprostol for Primary versus Secondary Prevention of Postpartum Haemorrhage – Do Costs Matter?," PLOS ONE, Public Library of Science, vol. 11(10), pages 1-8, October.
    • Handle: RePEc:plo:pone00:0164718
    DOI: 10.1371/journal.pone.0164718
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0164718
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0164718&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0164718?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Paal Joranger & Arild Nesbakken & Halfdan Sorbye & Geir Hoff & Arne Oshaug & Eline Aas, 2020. "Survival and costs of colorectal cancer treatment and effects of changing treatment strategies: a model approach," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(3), pages 321-334, April.
    2. Saha, Sanjib & Gerdtham, Ulf-G. & Toresson, Håkan & Minthon, Lennart & Jarl, Johan, 2018. "Economic Evaluation of Interventions for Screening of Dementia," Working Papers 2018:20, Lund University, Department of Economics.
    3. Mark Oppe & Daniela Ortín-Sulbarán & Carlos Vila Silván & Anabel Estévez-Carrillo & Juan M. Ramos-Goñi, 2021. "Cost-effectiveness of adding Sativex® spray to spasticity care in Belgium: using bootstrapping instead of Monte Carlo simulation for probabilistic sensitivity analyses," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(5), pages 711-721, July.
    4. Laurence M. Djatche & Stefan Varga & Robert D. Lieberthal, 2018. "Cost-Effectiveness of Aspirin Adherence for Secondary Prevention of Cardiovascular Events," PharmacoEconomics - Open, Springer, vol. 2(4), pages 371-380, December.
    5. Ties Hoomans & Johan Severens & Nicole Roer & Gepke Delwel, 2012. "Methodological Quality of Economic Evaluations of New Pharmaceuticals in the Netherlands," PharmacoEconomics, Springer, vol. 30(3), pages 219-227, March.
    6. Khan, Md. Tajuddin & Kishore, Avinash & Joshi, Pramod Kumar, 2016. "Gender dimensions on farmers’ preferences for direct-seeded rice with drum seeder in India:," IFPRI discussion papers 1550, International Food Policy Research Institute (IFPRI).
    7. Noémi Kreif & Richard Grieve & M. Zia Sadique, 2013. "Statistical Methods For Cost‐Effectiveness Analyses That Use Observational Data: A Critical Appraisal Tool And Review Of Current Practice," Health Economics, John Wiley & Sons, Ltd., vol. 22(4), pages 486-500, April.
    8. Barbara Graaff & Lei Si & Amanda L. Neil & Kwang Chien Yee & Kristy Sanderson & Lyle C. Gurrin & Andrew J. Palmer, 2017. "Population Screening for Hereditary Haemochromatosis in Australia: Construction and Validation of a State-Transition Cost-Effectiveness Model," PharmacoEconomics - Open, Springer, vol. 1(1), pages 37-51, March.
    9. Christopher Fitzpatrick & Katherine Floyd, 2012. "A Systematic Review of the Cost and Cost Effectiveness of Treatment for Multidrug-Resistant Tuberculosis," PharmacoEconomics, Springer, vol. 30(1), pages 63-80, January.
    10. Hareth Al-Janabi & Terry N. Flynn & Joanna Coast, 2011. "Estimation of a Preference-Based Carer Experience Scale," Medical Decision Making, , vol. 31(3), pages 458-468, May.
    11. Round, Jeff, 2012. "Is a QALY still a QALY at the end of life?," Journal of Health Economics, Elsevier, vol. 31(3), pages 521-527.
    12. Ching-Yun Wei & Ruben G. W. Quek & Guillermo Villa & Shravanthi R. Gandra & Carol A. Forbes & Steve Ryder & Nigel Armstrong & Sohan Deshpande & Steven Duffy & Jos Kleijnen & Peter Lindgren, 2017. "A Systematic Review of Cardiovascular Outcomes-Based Cost-Effectiveness Analyses of Lipid-Lowering Therapies," PharmacoEconomics, Springer, vol. 35(3), pages 297-318, March.
    13. Jose L Burgos & Thomas L Patterson & Joshua S Graff-Zivin & James G Kahn & M Gudelia Rangel & M Remedios Lozada & Hugo Staines & Steffanie A Strathdee, 2016. "Cost-Effectiveness of Combined Sexual and Injection Risk Reduction Interventions among Female Sex Workers Who Inject Drugs in Two Very Distinct Mexican Border Cities," PLOS ONE, Public Library of Science, vol. 11(2), pages 1-15, February.
    14. Najmiatul Fitria & Antoinette D. I. Asselt & Maarten J. Postma, 2019. "Cost-effectiveness of controlling gestational diabetes mellitus: a systematic review," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(3), pages 407-417, April.
    15. Thomas Grochtdreis & Hans-Helmut König & Alexander Dobruschkin & Gunhild von Amsberg & Judith Dams, 2018. "Cost-effectiveness analyses and cost analyses in castration-resistant prostate cancer: A systematic review," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-25, December.
    16. Kim Jeong & John Cairns, 2013. "Review of economic evidence in the prevention and early detection of colorectal cancer," Health Economics Review, Springer, vol. 3(1), pages 1-10, December.
    17. Susan Griffin & Helen Weatherly & Gerry Richardson & Mike Drummond, 2008. "Methodological issues in undertaking independent cost-effectiveness analysis for NICE: the case of therapies for ADHD," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 9(2), pages 137-145, May.
    18. William Wong & Josh Carlson & Rahber Thariani & David Veenstra, 2010. "Cost Effectiveness of Pharmacogenomics," PharmacoEconomics, Springer, vol. 28(11), pages 1001-1013, November.
    19. Fleurbaey, Marc & Zuber, Stéphane, 2017. "Fair management of social risk," Journal of Economic Theory, Elsevier, vol. 169(C), pages 666-706.
    20. G. Sagoo & S. Mohammed & G. Barton & G. Norbury & J. Ahn & C. Ogilvie & M. Kroese, 2015. "Cost Effectiveness of Using Array-CGH for Diagnosing Learning Disability," Applied Health Economics and Health Policy, Springer, vol. 13(4), pages 421-432, August.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0164718. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.