Evidence: economic issues

Evidence: economic issues

Cost effectiveness

The cost-effectiveness of tranexamic acid for significant haemorrhage following trauma was analysed for 3 countries based on the results of the CRASH-2 trial: in Tanzania, India and the UK. Costs were considered from a health service perspective and included cost of administering tranexamic acid and cost of additional days in hospital. The analysis took into account the life expectancy of different age groups in each country[17].

In the UK, the incremental cost per life year saved was $64 international dollars (converted using Purchasing Power Parities which, using 2011 data, equates to around £43). Administering tranexamic acid to trauma patients with bleeding within 3 hours of injury was estimated to save 755 life-years per 1,000 trauma patients in the UK[11].

On the basis of the CRASH-2 trial results, tranexamic acid has been included on the World Health Organization's (WHO) list of essential medicines, and incorporated into trauma treatment guidelines worldwide[18]. It has been estimated that the widespread use of tranexamic acid could save more than 100,000 lives per year around the world[19].


The price of tranexamic acid injection quoted in MIMS (October 2012) is £1.55 per 5 mL vial (100 mg/mL), excluding VAT[20]. The cost of tranexamic acid given at the doses in the CRASH-2 trial (initial treatment of 1 g infused intravenously over 10 minutes followed by intravenous infusion of 1 g over 8 hours) is £6.20.

Current drug usage

No recent information on tranexamic acid usage following acute trauma in the UK was available at the time this evidence summary was prepared.

[17] Guerriero C, Cairns J, Perel P et al. (2011) Cost-effectiveness analysis of administering tranexamic acid to bleeding trauma patients using evidence from the CRASH-2 trial. PLoS one; 6(5).

[18] Ker K, Kiriya J, Perel P et al. (2012) Avoidable mortality from giving tranexamic acid to bleeding trauma patients: an estimation based on WHO mortality data, a systematic literature review and data from the CRASH-2 trial. BMC Emergency Medicine 12(3).

[19] Roberts I, Perel P, Prieto-Merino D et al. (2012) Effects of tranexamic acid on mortality in patients with traumatic bleeding: prespecified analysis of data from randomised controlled trial. BMJ 345: e5839.