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[Comparative study of hospital costs associated with human albumin 20% (Vialebex((R)) 20%) or polyge |
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[Comparative study of hospital costs associated with
human albumin 20% (Vialebex((R)) 20%) or polygeline as a fluid
resuscitation strategy for cirrhotic ascites.]
Presse Med. 2007 Mar 20; [Epub ahead of print]
[Article in French]
Durand-Zaleski I, Alberti C, Guemas E, Golly D, Padrazzi B, Waegemans T.
Sante publique, Hopital Henri Mondor, Creteil (94).
OBJECTIVES:
To compare the hospital costs associated with two fluid resuscitation
strategies for cirrhotic ascites: one with human albumin 20% (Vialebex
((R)) 20%) and one with polygeline. METHODS: Multicenter prospective
randomized double-blinded comparative trial (that also compared
efficacy and tolerance). The economic evaluation was based on direct
medical costs throughout the follow-up period: days of hospitalization,
hospital consultations, medical procedures, and fluid resuscitation
products.
This cost-minimization study had a 6-month follow-up period.
Daily costs in euros were adjusted over a 30-day period. The study was
interrupted prematurely because of an alert due to the bovine origin of
the polygeline, and the inclusion objectives could therefore not be
met. RESULTS: The economic analysis included all patients in the
efficacy population (group receiving human albumin 20%: n=30,
polygeline group: n=38). It found a standardized cost per patient for
30 days of treatment that was significantly lower (p=0.004) for human
albumin 20% (median: 1915 euro; range: 1330-4105) than for polygeline
(median: 4612euro; range: 2138-12234). This difference is related
mainly to a reduction in the frequency and duration of hospitalization
in specialized units, but also to other aspects of management:
hospitalization in other departments, specific solutions for the study
products, and hospital procedures. CONCLUSION: The economic results of
this trial favor a fluid resuscitation strategy that uses human albumin
20% for cirrhotic patients. They are consistent with the clinical
results and help assess the cost-benefit ratio of human albumin 20% for
this indication.
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