Table 3Economic evidence profile of a targeted review of economic evaluations of mifepristone and misoprostol compared to misoprostol alone in the medical management of missed miscarriage

StudyLimitationsApplicabilityOther commentsIncrementalUncertainty
CostsEffectCost effectiveness

Devall 2021

Mifepristone and misoprostol versus placebo and misoprostol for resolution of miscarriage in women diagnosed with missed miscarriage: the MifeMiso RCT

Minor limitationsDirectly applicableEconomic evaluation alongside RCTMifepristone and misoprostol −£1820.0004 QALYsMifepristone and misoprostol dominateMonte Carlo simulation using non-parametric bootstrapping of mean QALYs, and costs suggested there was a greater than 50% probability that Mifepristone and misoprostol was cost-effective
1

Modelling was undertaken over a short time horizon and no probabilistic sensitivity analysis was conducted.

2

Specific costs and disutilities of drug-related adverse events could not be explicitly modelled. Adverse events were captured by modelling treatment-specific withdrawal rates. This may have overestimated the cost effectiveness of maintenance treatment.

3

The cost-effectiveness model was designed to reflect the management of Crohn’s disease in the Swedish healthcare setting. Although a cost per QALY estimate was reported, it was not based on health-related quality of life values elicited from patients.

From: Medical management of miscarriage

Cover of Medical management of miscarriage
Medical management of miscarriage: Ectopic pregnancy and miscarriage: Evidence review D.
NICE Guideline, No. 126.
Copyright © NICE 2023.

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