Exploring the cost-effectiveness of Albumin-enhanced IV crystalloids in sepsis fluid resuscitation
<p><strong>Background: </strong>This study aims to evaluate the cost-effectiveness of using albumin as well as crystalloids compared to the baseline use of crystalloids alone in the management of sepsis in the context of the Egyptian healthcare system. crucial for healthcare polic...
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Academy Publishing Center
2024-09-01
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| Series: | Advances in Medical, Pharmaceutical and Dental Research |
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| Online Access: | http://apc.aast.edu/ojs/index.php/AMPDR/article/view/914 |
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| author | Mohamed Metwally Mosly Hesham Metwalli Mousli Iman Mohamed Momtaz Ahmed Mohamed Ibrahim Affify Abdou |
| author_facet | Mohamed Metwally Mosly Hesham Metwalli Mousli Iman Mohamed Momtaz Ahmed Mohamed Ibrahim Affify Abdou |
| author_sort | Mohamed Metwally Mosly |
| collection | DOAJ |
| description | <p><strong>Background: </strong>This study aims to evaluate the cost-effectiveness of using albumin as well as crystalloids compared to the baseline use of crystalloids alone in the management of sepsis in the context of the Egyptian healthcare system. crucial for healthcare policymakers and managers, particularly in settings where reasonable cost containment is a priority.</p><p><strong>Methods: </strong>A decision tree model was created using TreeAge Healthcare Pro® software to compare two treatment groups for patients with severe sepsis or septic shock: one receiving only crystalloid fluids and the other receiving both crystalloid fluids and human albumin. The treatments were compared using the Incremental Cost-Effectiveness Ratio (ICER) and Net Monetary Benefit (NMB). Deterministic and probabilistic sensitivity analyses were conducted to assess the robustness of the results.</p><p><strong>Results: </strong>Although comparing the cost-effectiveness of both alternatives showed an ICER of 162,00 L.E in favor of the albumin plus crystalloids use in sepsis cases management, there was no dominance of either alternative over the other in terms of the cost-effectiveness plane. By considering the NMB relevant to each individual alternative, the albumin plus crystalloids choice resulting in (-323,485 L.E) while the use of crystalloids alone resulting in higher NMB estimate of (-312,285 L.E). The results showed a considerable sensitivity to the cost of Albumin, the probabilistic sensitivity analysis showed robustness of the base case results over the estimated willingness to pay threshold of 160,000 L.E.</p><p><strong>Conclusions:</strong> The study showed that albumin-based management of sepsis and septic shoch patients is not a cost-effective choice up to the WTP threshold of 300,000 L.E.</p><p> </p><p><strong>Received: 04 July 2024</strong></p><p><strong>Accepted: 26 August 2024</strong></p><p><strong>Published: 19 September 2024</strong></p> |
| format | Article |
| id | doaj-art-ca4dcd7a3fcf40db8c512c48a9bbf5e5 |
| institution | Kabale University |
| issn | 2812-488X 2812-4898 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | Academy Publishing Center |
| record_format | Article |
| series | Advances in Medical, Pharmaceutical and Dental Research |
| spelling | doaj-art-ca4dcd7a3fcf40db8c512c48a9bbf5e52025-08-20T03:50:01ZengAcademy Publishing CenterAdvances in Medical, Pharmaceutical and Dental Research2812-488X2812-48982024-09-014213013710.21622/AMPDR.2024.04.2.914389Exploring the cost-effectiveness of Albumin-enhanced IV crystalloids in sepsis fluid resuscitationMohamed Metwally Mosly0Hesham Metwalli Mousli1Iman Mohamed Momtaz Ahmed2Mohamed Ibrahim Affify Abdou3Faculty of Pharmacy - Arab Academy for Science and Technology (AAST) - Alexandria - Egypt.Faculty of Pharmacy - Arab Academy for Science and Technology (AAST) - Alexandria - Egypt.HOD of Clinical Pharmacy at Andalusia Hospital., Alexandria – Egypt.Associate Professor of Critical Care Medicine – Faculty of Medicine - Cairo University, Cairo – Egypt.<p><strong>Background: </strong>This study aims to evaluate the cost-effectiveness of using albumin as well as crystalloids compared to the baseline use of crystalloids alone in the management of sepsis in the context of the Egyptian healthcare system. crucial for healthcare policymakers and managers, particularly in settings where reasonable cost containment is a priority.</p><p><strong>Methods: </strong>A decision tree model was created using TreeAge Healthcare Pro® software to compare two treatment groups for patients with severe sepsis or septic shock: one receiving only crystalloid fluids and the other receiving both crystalloid fluids and human albumin. The treatments were compared using the Incremental Cost-Effectiveness Ratio (ICER) and Net Monetary Benefit (NMB). Deterministic and probabilistic sensitivity analyses were conducted to assess the robustness of the results.</p><p><strong>Results: </strong>Although comparing the cost-effectiveness of both alternatives showed an ICER of 162,00 L.E in favor of the albumin plus crystalloids use in sepsis cases management, there was no dominance of either alternative over the other in terms of the cost-effectiveness plane. By considering the NMB relevant to each individual alternative, the albumin plus crystalloids choice resulting in (-323,485 L.E) while the use of crystalloids alone resulting in higher NMB estimate of (-312,285 L.E). The results showed a considerable sensitivity to the cost of Albumin, the probabilistic sensitivity analysis showed robustness of the base case results over the estimated willingness to pay threshold of 160,000 L.E.</p><p><strong>Conclusions:</strong> The study showed that albumin-based management of sepsis and septic shoch patients is not a cost-effective choice up to the WTP threshold of 300,000 L.E.</p><p> </p><p><strong>Received: 04 July 2024</strong></p><p><strong>Accepted: 26 August 2024</strong></p><p><strong>Published: 19 September 2024</strong></p>http://apc.aast.edu/ojs/index.php/AMPDR/article/view/914sepsis, cost-effectiveness, albumin, fluid, egypt, adult. |
| spellingShingle | Mohamed Metwally Mosly Hesham Metwalli Mousli Iman Mohamed Momtaz Ahmed Mohamed Ibrahim Affify Abdou Exploring the cost-effectiveness of Albumin-enhanced IV crystalloids in sepsis fluid resuscitation Advances in Medical, Pharmaceutical and Dental Research sepsis, cost-effectiveness, albumin, fluid, egypt, adult. |
| title | Exploring the cost-effectiveness of Albumin-enhanced IV crystalloids in sepsis fluid resuscitation |
| title_full | Exploring the cost-effectiveness of Albumin-enhanced IV crystalloids in sepsis fluid resuscitation |
| title_fullStr | Exploring the cost-effectiveness of Albumin-enhanced IV crystalloids in sepsis fluid resuscitation |
| title_full_unstemmed | Exploring the cost-effectiveness of Albumin-enhanced IV crystalloids in sepsis fluid resuscitation |
| title_short | Exploring the cost-effectiveness of Albumin-enhanced IV crystalloids in sepsis fluid resuscitation |
| title_sort | exploring the cost effectiveness of albumin enhanced iv crystalloids in sepsis fluid resuscitation |
| topic | sepsis, cost-effectiveness, albumin, fluid, egypt, adult. |
| url | http://apc.aast.edu/ojs/index.php/AMPDR/article/view/914 |
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