COST-EFFECTIVENESS OF RECOMBINANT-HUMAN-ERYTHROPOIETIN VERSUS TRANSFUSIONS IN THE TREATMENT OF ZIDOVUDINE-RELATED ANEMIA IN HIV-INFECTED CHILDREN

The objectives of this study were to compare the costs and benefits of recombinant human erythropoietin (r-HuEPO) relative to repeated trans fusions in the treatment of zidovudine (AZT)-related anemia among HIV- infected children. The study was based on a tertiary care Canadian Ped iatric Hospital Model. A decision analytic structure was used for the evaluation of cost-effectiveness. The decision tree involved two optio ns. In option A:r-HuEPO, subjects receive r-HuEPO three times weekly a t home for 1 year, whereas in B:no r-HuEPO, transfusions are given on a monthly basis in a medical short-stay unit over a 1-year period. Pro babilities of various outcomes and downstream events were obtained fro m a literature review. The analysis was conducted from the perspective of the health-care system and utilized standard cost-effectiveness me thodology. The results indicated that for every child receiving r-HuEP O, the total cost is Can $11,245 for 1 year compared with $3,130 per y ear for those in B:no r-HuEPO. The incremental cost effectiveness of A :r-HuEPO relative to B:no r-HuEPO is $1,373 per transfusion episode av erted. The order of magnitude of the results was not significantly aff ected by changes in any of the assumptions used for the cost estimates or baseline probability values.