PROJECT

Cost-effectiveness of plasma exchange (PLEX) treatment for rodenticide poisoning cases (Yellow Phosphorous) with severe liver injury in Tamil Nadu

July 2025 - April 2026

Objectives:

To evaluate the cost-effectiveness of PLEX as an adjunct to standard medical treatment compared with standard medical treatment alone in the management of YP rodenticide poisoning in India. To assess the cost-effectiveness of PLEX among patients with severe liver injury in Tamil Nadu. To estimate the additional budget required for the potential implementation of PLEX in public health facilities.

Study Overview:

Rodenticide poisoning is a significant public health concern in India and is associated with high mortality, prolonged hospitalisation and substantial treatment costs. Yellow phosphorus (YP) compounds are a major cause of acute hepatotoxicity and acute liver failure. This HTA aims to evaluate the cost-effectiveness of plasma exchange (PLEX) as an adjunct to standard medical treatment compared with standard medical treatment alone in the management of YP rodenticide poisoning in India.

Study Approach:

A deterministic decision-analytic model was developed to compare PLEX plus standard medical treatment with standard medical treatment alone over the defined analytical time horizon. The model incorporated direct medical costs and health outcomes expressed as mortality and QALYs. Cost inputs were derived from hospital-based resource utilisation and published literature.

Expected Public Health Impact:

PLEX was associated with improved health outcomes but higher overall costs compared with SMT alone. The intervention resulted in an incremental gain of 3.77 QALYs and 0.179 deaths averted with an additional cost of ₹3,004.53 per patient. The estimated ICERs were ₹797 per QALY gained and ₹16,785 per death averted, indicating favourable cost-effectiveness.