| Study | Applicability | Limitations | Other comments | Incremental cost | Incremental effects (mean per patient) | Cost-effectiveness | Uncertainty |
|---|---|---|---|---|---|---|---|
| Rajesparan 2009251 (UK) | Partially applicable(a) | Potentially serious limitations(b) | Within trial analysis (RCT) of adults undergoing total hip replacement. Analysis of individual level resource use with unit costs applied. TXA administered intravenously. | Saves £54(c) | Saves 0.1 units of allogeneic blood transfused (per patient transfused)(d) | Tranexamic acid is dominant | No analysis reported |
| Alshryda 2013A9 (UK) | Partially applicable(e) | Potentially serious limitations(f) | Within trial analysis (RCT) of adults undergoing total hip replacement. Analysis of individual level resource use with unit costs applied. TXA administered topically (intra-articular) | Saves £305(g) | Saves 0.46 units of allogeneic blood transfused (per patient transfused)(h) | Tranexamic acid is dominant | Bootstrapping of costs. Tranexamic acid saves £304 (CI -613 to -15, p=0.046) |
Health effects not expressed in terms of QALYs. Study does not include all interventions in protocol.
Short follow up which does not account for impact of potential risks and costs associated with transfusion related adverse events and illness, costs do not account for resource use such as staff time or for treatment of thrombotic complications and no analysis of uncertainty conducted.
UK pounds, year NR, assumed to be 2009 UK pounds based on the date publication submission. Resource use from within study. Unit cost of allogeneic blood and cost of tranexamic acid from institution.
Other health outcomes presented and available in full evidence table. Percentage requiring allogeneic blood transfusion, volume transfused, blood loss and rate of clinical post-operative deep vein thrombosis confirmed by venography from within study.
Health effects not expressed in terms of QALYs. Study does not include all interventions in protocol.
Short follow up which does not account for impact of potential risks and costs associated with transfusion related adverse events and illness. Costs do not account for resource use such as staff time and the cost of complications.
2010 UK pounds. Resource use from within study. Resource use from within study. Source of unit cost of allogeneic blood, hospital stay per diem and cost of tranexamic acid not reported but likely to be from institution. Cost of complications and staff time not estimated.
Other health outcomes presented and available in full evidence table. Percentage requiring allogeneic blood transfusion and volume transfused, blood loss, length of stay, complications including deep vein thrombosis, EQ-5D from within study.
From: 6, Alternatives to blood transfusion for patients having surgery: Cell salvage and tranexamic acid
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