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Table 1 Model input parameters with upper and lower limits for sensitivity analysis

From: Cost-effectiveness and budget impact of adding tranexamic acid for management of post-partum hemorrhage in the Indian public health system

Input parameter

Base-case value

Upper limit

Lower limit

Source

Age start

21 years a

16.8

25.2

[29]

The proportion of PPH cases that are atonic

0.80 a

0.64

0.96

[37]

The relative risk of further interventions with TXA

0.96 a

0.76

1.15

Calculated from [32]

The relative risk of further interventions with SOC

1.05

0.84

1.26

Calculated from [32]

Risk of further intervention events with TXA

0.22

0.18

0.27

Calculated from [32]

Risk of further intervention events with SOC

0.23 a

0.19

0.28

Calculated from [32]

UBT insertion for atonic PPH at primary

0.19 a

0.15

0.22

[29]

UBT insertion for atonic PPH at secondary

0.33 a

0.26

0.40

[29]

UBT insertion for atonic PPH at tertiary

0.48 a

0.39

0.58

[29]

Clinical effectiveness of condom-UBT

0.92 a

0.74

0.98

[35]

The relative risk for death due to bleeding with TXA

0.69

0.52

0.91

Calculated from [32]

Risk of death due to bleeding with standard care (SOC)

0.02 a

0.01

0.02

Calculated from [32]

Direct hysterectomy for uncontrolled atonic PPH after UBT intervention

0.15 a

0.12

0.18

[34]

Hysterectomy after devascularization

0.22 a

0.18

0.26

[34]

The relative risk for all-cause mortality with TXA

0.88

0.74

1.05

Calculated from [32]

Risk of all-cause mortality rate with standard care

0.03 a

0.02

0.03

Calculated from [32]

Risk of ICU admission for UBT uncontrolled cases

0.77 a

0.62

0.92

[36]

Risk of ICU admission for UBT-controlled cases

0.03 a

0.02

0.03

[36]

Traumatic PPH controlled with suturing and local measures

0.45 a

0.36

0.55

[34]

Cost of medical management with TXA at the primary level

451

353

560

From the Primary costing study

Cost of medical management with TXA at the secondary level

1685

1405

1945

Cost of medical management with TXA at tertiary level

2812

2433

3176

Cost of medical management with SOC at the primary level

241

139

353

Cost of medical management with SOC at the secondary level

1475

1207

1740

Cost of medical management with SOC at tertiary

2601

2171

3053

Cost of UBT insertion for atonic PPH at the primary level

281

254

308

Cost of UBT insertion for atonic PPH at the secondary level

531

446

618

Cost of UBT insertion for atonic PPH at tertiary level

1303

1170

1433

Cost of devascularisation surgery at the secondary level

4991

3986

5997

Cost of devascularisation surgery at tertiary level

8271

6483

10,109

Cost of hysterectomy at the secondary level

7535

6150

9016

Cost of hysterectomy at tertiary level

11,462

9529

13,343

Cost of indoor patient (IPD) admission for PPH at the secondary level

2230

1290

3310

Cost of IPD admission for PPH at tertiary level

3273

2387

4236

Cost of ICU admission for PPH at the tertiary level

9901

4759

15,731

Cost of local management for traumatic at primary

264

177

351

Cost of local management for traumatic at secondary

387

302

470

Cost of local management for traumatic at tertiary

689

532

851

Cost of patient referral

1096 a

876

1315

[38]

Out-of-pocket expenditure for childbirth

3015 a

2412

3618

[39]

Number of TXA doses

1.29

1.28

1.30

[40]

Utility at death

0.00

0

0

 

Utility at discharge (medical management)

0.930

0.910

0.940

[40]

Utility for medical plus conservative measures

0.895

0.892

0.897

[40]

Utility short-term devascularization (42 days)

0.565 a

0.300

0.870

[41]

Utility devascularization long term (Beyond 42 days)

0.909

0.500

0.960

[41]

Utility hysterectomy short-term (42 days)

0.560 a

0.448

0.672

[42]

Utility hysterectomy long-term (beyond 42)

0.880 a

0.704

1.000

[42]

Utility ICU admission (1.5 days)

0.490a

0.392

0.588

[42]

Discount rate

0.030

0.000

0.050

[43]

  1. aThe upper and lower limit for these parameters are calculated by assuming a 20 percent variation on both sides. For remaining parameters, limits are obtained either from primary sources or by calculating confidence interval limits