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Cost-effectiveness of uterine tamponade devices for the treatment of postpartum hemorrhage: A systematic review.

Vogel JP, Wilson AN, Scott N, Widmer M, Althabe F, Oladapo OT

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  • Journal International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

  • Published 30 Oct 2020

  • Volume 151

  • ISSUE 3

  • Pagination 333-340

  • DOI 10.1002/ijgo.13393

Abstract

Uterine tamponade is widely promoted for treating refractory postpartum hemorrhage (PPH); however, its cost-effectiveness may vary depending on unit costs and setting.

To review available data on cost-effectiveness of uterine tamponade devices when used for PPH treatment.

PubMed and EMBASE were searched (1980 to January 2020), as well as the National Health Services Economic Evaluation database from inception (1995) to March 2015.

Eligible studies were any type of economic evaluation, or effectiveness studies that provided cost or economic data.

Two reviewers independently screened studies, extracted data, and assessed quality.

Eleven studies using a range of devices (condom catheter, uterine suction devices, Bakri, Inpress, Ellavi) were identified. Cost of condom catheter devices or kits ranged from US$0.64 to US$6, whereas purpose-designed device costs were up to US$400. Two studies that took a health system perspective assessed the cost-effectiveness of using uterine balloon tamponade and suggested that it was highly cost-effective because of the low cost per disability-adjusted life-year averted, although both used effect estimates from case series.

Evidence on the cost-effectiveness of uterine tamponade devices was limited and not generalizable. Rigorous economic evaluations based on updated effect estimates are needed.