title: Costs of the use of carbetocin in the prevention of uterine atony following delivery of the infant by Caesarean section - retrospective multicenter study.
abstract: The aim of this study was to compare the costs of using carbetocin in the prevention of uterine atony following delivery of the infant by Cesarean section (C-section) under epidural or spinal anesthesia with standard methods of prevention (SMP).
  
  
  
  This retrospective multicenter study was based on data from three medical centers. A questionnaire was developed to gather patient records on consumption and costs of resources related to C-section, prevention of uterine atony and postpartum hemorrhage (PPH) treatment. Six subpopulations were considered, depending on patient characteristics. The analysis covered two perspectives: that of the hospital and of the public payer.
  
  
  
  The subpopulations were homogenous, which was a premise for pooling the data. The use of carbetocin in the prevention of uterine atony following Cesarean section generates savings for hospital in comparison with SMP (oxytocin) in 5 of 6 subpopulations. The biggest savings were observed amongst patients who experienced severe PPH and reached 2.6-6.2 thousand PLN per patient. Costs of services related to C-section borne by the hospitals were higher than the refund received from a public payer. The greatest underestimation reached 12.1 thousand PLN per patient. Nevertheless, loss generated by this underfunding was lower in carbetocin versus oxytocin group.
  
  
  
  The use of carbetocin instead of SMP gives hospitals an opportunity to make savings as well as to reduce losses resulting from the underfunding of the services provided by the National Health Fund.
authors.forename: Maciej
authors.initials: M
authors.lastname: Sobkowski
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Celewicz
authors.forename: Jarosław
authors.initials: J
authors.lastname: Kalinka
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Szymanowski
authors.forename: Marcin
authors.initials: M
authors.lastname: Serafin
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Śmieja
authors.forename: Anna
authors.initials: A
authors.lastname: Grzymała-Figura
authors.forename: Kinga
authors.initials: K
authors.lastname: Pacocha
authors.affiliation: Instytut Arcana, Kraków. ipieniazek@inar.pl.
authors.forename: Izabela
authors.initials: I
authors.lastname: Pieniążek
authors.forename: Jacek
authors.initials: J
authors.lastname: Walczak
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Żyła
authors.forename: Adam
authors.initials: A
authors.lastname: Bierut
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural; D000775:Anesthesia, Spinal; D002585:Cesarean Section / Q000009:adverse effects*; D016527:Drug Costs; D005260:Female; D006801:Humans; D010120:Oxytocics / Q000191:economics* / Q000627:therapeutic use*; D010121:Oxytocin / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D011183:Postoperative Complications / Q000517:prevention & control*; D006473:Postpartum Hemorrhage / Q000517:prevention & control; D011247:Pregnancy; D012189:Retrospective Studies; D014593:Uterine Inertia / Q000517:prevention & control*
chemical_list: D010120:Oxytocics; D010121:Oxytocin; C020731:carbetocin
keywords: carbetocin; costs; postpartum hemorrhage; uterine atony