Economic evaluation of tranexamic acid for the treatment of acute gastrointestinal bleeding: a cost-effectiveness analysis using data from the HALT-IT randomised controlled trial

Objective To perform an economic evaluation of tranexamic acid (TXA) versus no-TXA, in addition to current clinical practice, for acute gastrointestinal bleeding, using the results HALT-IT trial ( NCT01658124 ), a large randomised controlled which included 11 937 patients. Design A cost-effectiveness modelling analysis, performed over lifetime time horizon. Setting The analysis was from UK health service perspective. Participants model includes adults with bleeding. Outcomes measures reports costs Great British pounds 2021 and outcomes as life years (LYs) quality-adjusted (QALYs). Cost-effectiveness evaluated incremental ratios (ICERs), reported cost per QALY gained. Methods Markov developed calculate overall TXA administration no-TXA. used data treatment effectiveness trial, showed that bleeding did not reduce all-cause mortality (risk ratio 1.03, 95% CI 0.92 1.16) compared Data on health-related quality life, long-term risks were derived literature. Costs effects are discounted at 3.5% annum. Results associated marginally fewer LYs QALYs, lower costs, than without TXA. ICER no-TXA £1576 LY gained £2209 No-TXA 64% likely be cost-effective £20 000 willingness-to-pay threshold, while 36% cost-effective. Conclusion Though inexpensive, patients is unlikely