Bakri balloon vs. jada device for treatment of postpartum hemorrhage: a cost-effective analysis

Postpartum hemorrhage (PPH) remains a leading cause of maternal morbidity and mortality with an increasing incidence in the U.S. Intrauterine balloon tamponade devices (IBTD) are a common treatment option for PPH that is not responsive to first-line treatments. The Bakri balloon is a commonly utilized IBTD, however the Jada device has recently emerged as a highly effective option. Our goal was to compare two IBTDs, the Bakri balloon and the Jada device, for treatment of PPH to determine the most cost-effective strategy by comparing maternal outcomes. A cost-effectiveness model was created using TreeAge 2022 software to compare two IBTDs, the Bakri balloon and the Jada device, for treatment of PPH. We used a theoretical cohort of 75,000 women, the approximate number of women in the U.S. annually affected by PPH that is not responsive to first-line treatments. Outcomes included administration of blood products, requirement of an additional surgical procedure, ICU admission, maternal death, cost, and quality-adjusted life years (QALYs). Probabilities, utilities, and costs were derived from the literature, and the willingness-to-pay (WTP) threshold was $100,000/QALY. Univariate sensitivity analysis was used to assess the robustness of the results. Comparing the Bakri balloon to the Jada device for treatment of PPH, the Jada device was cost-effective and cost-saving. In our theoretical cohort of 75,000 women, the Jada device was the dominant strategy as it led to 4,836 fewer women receiving blood products, 7,388 fewer additional procedures, 5,176 fewer ICU admissions, 143 fewer maternal deaths, an annual cost-saving of $145 million, and 134,603 additional QALYS. Sensitivity analysis demonstrated that the Jada device remained cost-saving up to a cost of $2,370. In our theoretical cohort, utilizing the Jada device for treatment of PPH as compared to the Bakri balloon leads to fewer adverse outcomes, decreased costs, and increased QALYs.View Large Image Figure ViewerDownload Hi-res image Download (PPT)