title: Cost-utility analysis of an adjunctive recombinant activated factor VIIa for on-demand treatment of bleeding episodes in dengue haemorrhagic fever.
abstract: The present study aimed to assess the cost-utility analysis of using an adjunctive recombinant activated factor VIIa (rFVIIa) in children for controlling life-threatening bleeding in dengue haemorrhagic fever (DHF)/dengue shock syndrome (DSS). We constructed a decision-tree model, comparing a standard care and the use of an additional adjuvant rFVIIa for controlling life-threatening bleeding in children with DHF/DSS. Cost and utility benefit were estimated from the societal perspective. The outcome measure was cost per quality-adjusted life years (QALYs). Overall, treatment with adjuvant rFVIIa gained QALYs, but the total cost was higher. The incremental cost-utility ratio for the introduction of adjuvant rFVIIa was $4241.27 per additional QALY. Sensitivity analyses showed the utility value assigned for calculation of QALY was the most sensitive parameter. We concluded that despite high cost, there is a role for rFVIIa in the treatment of life-threatening bleeding in patients with DHF/DSS.
authors.affiliation: aInstitute for Research, Development and Innovation, International Medical University, Kuala Lumpur, Malaysia bChulalongkorn University, Bangkok, Thailand cSchool of Medicine, International Medical University, Kuala Lumpur, Malaysia *Cho Naing and Yong Poovorawan contributed equally to the writing of this article.
authors.forename: Cho
authors.initials: C
authors.lastname: Naing
authors.forename: Yong
authors.initials: Y
authors.lastname: Poovorawan
authors.forename: Joon Wah
authors.initials: JW
authors.lastname: Mak
authors.forename: Kyan
authors.initials: K
authors.lastname: Aung
authors.forename: Pirom
authors.initials: P
authors.lastname: Kamolratankul
mesh_terms: D000293:Adolescent; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D015942:Factor VIIa / Q000191:economics* / Q000627:therapeutic use*; D006470:Hemorrhage / Q000150:complications / Q000188:drug therapy* / Q000191:economics*; D006801:Humans; D019057:Quality-Adjusted Life Years; D011994:Recombinant Proteins / Q000191:economics / Q000627:therapeutic use; D019595:Severe Dengue / Q000150:complications / Q000188:drug therapy* / Q000191:economics*
chemical_list: D011994:Recombinant Proteins; C103587:recombinant FVIIa; D015942:Factor VIIa