Cardiothoracic & vascular anesthesia
Cost-effectiveness of Fibrinogen Concentrate vs Cryoprecipitate for Treating Acquired Hypofibrinogenemia in Bleeding Adult Cardiac Surgical Patients
An erratum to this article was published (JAMA Surg, 1 Mar 2026 ↗)
Authors' conclusion
Fibrinogen concentrate is cost-effective when compared with cryoprecipitate in most bleeding adult patients who underwent cardiac surgery with acquired hypofibrinogenemia requiring fibrinogen replacement.
Study context
- Population
- Adults bleeding after cardiac surgery with acquired hypofibrinogenemia requiring fibrinogen replacement, 4 hospitals in Ontario, Canadasubset of FIBERS
- Participants
- 495 adults
- Comparison
- Fibrinogen concentrate vs cryoprecipitate
- Primary endpoint
- Cost-effectiveness: ABP transfusion (7-day) and in-hospital resource utilization (28-day) costs; incremental net benefit
- Follow-up
- 28 days
Methodological detailswithin-trial cost-effectiveness analysis, multicentre, net benefit regression, predefined subgroups, February 2017 to November 2018
- Within-trial cost-effectiveness analysis
- Multicentre
- Net benefit regression
- Predefined subgroups
- February 2017 to November 2018
Primary result
As reported in the abstract
Fibrinogen concentrate
CAD $38 180
Median · IQR CAD $26 350 [USD $19 622]-CAD $65 080 [USD $48 463]
Cryoprecipitate
CAD $38 790
Median · IQR CAD $26 180 [USD $19 495]-CAD $70 380 [USD $52 409]
Positive after excluding critically ill patients (11%); probability cost-effective 86% and 97% at $0 and CAD $2000 (USD $1489) willingness-to-pay
Further findings
Median CAD $
| Outcome | Fibrinogen concentrate | Cryoprecipitate |
|---|---|---|
| Total 7-day ABP cost | 2280 (IQR CAD $930 [USD $692]-CAD $4970 [USD $3701]) | 2770 (IQR CAD $1140 [USD $849]-CAD $5000 [USD $3723]) |
Allogeneic blood product (ABP) transfusions
- Similar in both treatment groups
Net benefit in nonelective and critically ill patients (subgroup)
- Highly uncertain
Safety
Adverse events
- Similar in both treatment groups
Original publication
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