Despite higher cost per course of PPH prevention with carbetocin versus oxytocin, the total direct medical cost saving and QALY gained by carbetocin were generated from the significant reduction of PPH ≥500 mL (RR 0.72 (95% CI 0.56 to 0.93)) when compared to oxytocin (as demonstrated by the network meta-analysis) [8]. This evidence concerns the gene OXT and pulmonary arterial hypertension.