| Title: |
Cost‐Effectiveness of Ultra‐Early Tranexamic Acid as Add‐On to Standard Care After Subarachnoid Hemorrhage (ULTRA Trial) |
| Authors: |
Denneman, Nadine; Post, René; van Eekelen, Rik; Tjerkstra, Maud A.; Kempeneers, Marinus A.; Labib, Homeyra; Germans, Menno R.; Vergouwen, Mervyn D. I.; Jellema, Korne; Koot, Radboud W.; Kruyt, Nyika D.; Wolfs, Jasper F. C.; Nanda, Dharmin; Van Der Pol, Bram; Roks, Gerwin; De Beer, Frank; Reichman, Loes J. A.; Brouwers, Paul J. A. M.; Vincent, H. Kwa; Bienfait, Henri P.; Boogaarts, Hieronymus D.; Klijn, Catharina J. M.; van den Berg, René; Coert, Bert A.; Horn, Janneke; Majoie, Charles B. L. M.; Rinkel, Gabriël J. E.; Roos, Yvo B. W. E. M.; Vandertop, W. Peter; Verbaan, Dagmar |
| Contributors: |
Fonds NutsOhra |
| Source: |
European Journal of Neurology ; volume 32, issue 8 ; ISSN 1351-5101 1468-1331 |
| Publisher Information: |
Wiley |
| Publication Year: |
2025 |
| Collection: |
Wiley Online Library (Open Access Articles via Crossref) |
| Description: |
Objective To evaluate the cost‐effectiveness and cost–utility of adding ultra‐early and short‐term administration of tranexamic acid (TXA) to standard care in patients with subarachnoid hemorrhage (SAH). Materials and Methods An economic evaluation was performed alongside the ultra‐early tranexamic acid after subarachnoid hemorrhage (ULTRA) trial. The main outcomes were the incremental cost‐effectiveness ratio (ICER), expressed as costs per one‐point increase in modified Rankin scale (mRS) score, and the incremental cost–utility ratio (ICUR), expressed as costs per quality‐adjusted life‐year (QALY). Cost‐effectiveness acceptability curves (CEACs) were visualized with varying ICER cut‐offs. Bootstrapping techniques and sensitivity analyses were performed to account for uncertainty. Results The ULTRA trial included 955 patients, with 480 assigned to the TXA group and 475 to the control group. The mean mRS score was 3.4 (95% CI: 3.2–3.5) in the TXA group and 3.2 (95% CI: 3.0–3.4) in the control group. The mean QALY was 0.26 (95% CI: 0.24–0.28) in the TXA group and 0.28 (95% CI: 0.26–0.30) in the control group. Mean costs were €62,180 (95% CI: 57,589–66,913) in the TXA group and €58,624 (95% CI: 53,693–63,955) in the control group. The probability of treatment with TXA being cost‐effective ranged from 4% to 16% for mRS and from 8% to 16% for QALYs. Conclusions Ultra‐early and short‐term administration of TXA to patients with SAH is not cost‐effective. Therefore, we recommend against using TXA for this patient group. Trial Registration: Netherlands Trial Register: NTR3272. ClinicalTrials.gov identifier: NCT02684812 |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1111/ene.70208 |
| Availability: |
https://doi.org/10.1111/ene.70208; https://onlinelibrary.wiley.com/doi/pdf/10.1111/ene.70208 |
| Rights: |
http://creativecommons.org/licenses/by-nc/4.0/ |
| Accession Number: |
edsbas.B8AA0CAC |
| Database: |
BASE |