PHARMACOECONOMICS ANALYSIS IN A PEDIATRIC POPULATION

Background. Pharmacoeconomics is becoming increasingly important in th e health-care environment, but pharmacoeconomic studies are fraught wi th problems. Pharmacoeconomics can be applied to analysis of the benef its of pharmacologic hemostasis. Methods. This article reviews the ava ilable methods of pharmacoeconomic analysis and their inherent methodo logic concerns. It reviews pharmacoeconomic studies of pharmacologic h emostasis, with particular focus on the Pediatric Reoperative Open Hea rt Surgery study. In this study, patients were randomized to receive e ither high-dose aprotinin, low-dose aprotinin, or placebo. Results wer e analyzed from the viewpoint of cost-benefit, cost-effectiveness calc ulated with use of a roll-back decision tree, and cost-effective ratio s. Results. Cost-benefit analysis showed low-dose aprotinin to have a greater cost-benefit than high-dose aprotinin, cost-effectiveness anal ysis and analysis of cost-effective ratios showed high-dose aprotinin to be more cost-effective than low-dose aprotinin, and all analyses sh owed aprotinin to be preferable to placebo. Conclusions. Aprotinin in pediatric repeat open heart operations not only has a cost-benefit but is cost-effective as well. (C) 1998 by The Society of Thoracic Surgeo ns.