A Cost Minimization Comparison of Two Surfactants—Beractant and Poractant alfa—Based Upon Prospectively Designed, Comparative Clinical Trial Data

Abstract

CLINICAL INVESTIGATIONOBJECTIVES To compare the pharmacoeconomic profiles of beractant (Survanta ® , Ross Laboratories, Columbus, Ohio) and poractant alfa (Curosurf ® , DEY LP, Napa, CA) via a cost-minimization analysis. METHODS This analysis was based upon clinical data from two previously published studies (Speer C, et al. Arch Dis Child 1995;72: F8-13; and Ramanathan R, et al. Am J Perinatol 2004; 21:109-19) where investigators found significant differences in the number of doses required to achieve a similar clinical response. Our analyses employed several models based upon single-use or multiple-use of single-use vial scenarios, average wholesale pricing, and costs computed on a per-patient basis. Model 1 involved single-dose vials and mean weight of the infants (both trials). Models 2 and 3, based on individual patient weights, assessed single-dose and multiple-use of single-dose vials cost scenarios, respectively. Individual patient weights allowed for statistical evaluation in Models 2 and 3. RESULTS Model 1 savings with poractant alfa treatment was $949.67 (53%) based upon Speer and $617.90 (46%) based upon Ramanathan. Models 2 and 3 reported savings for poractant alfa of $220.50 (20%) (P ϭ 0.11) and $180 (20%) (P ϭ 0.018), respectively over beractant. CONCLUSIONS These analyses would suggest poractant alfa may offer a less costly, clinically-equivalent option. Savings may vary with vial usage and mix, patient weight distribution, and how surfactants are used in practice. Institutions utilizing surfactants may wish to examine usage patterns, dosing protocols, and patient mix to determine what potential savings may exist.

Surfactant therapy in preterm infants with respiratory distress syndrome and in near-term or term newborns with acute RDS

“…In a pharmacoeconomic analysis of poractant alfa vs beractant using the data from two randomized studies, Marsh et al 28 showed a 20-53% reduction in cost with poractant alfa compared with beractant.…”

An Open Label Comparison of Calfactant and Poractant Alfa Administration Traits and Impact on Neonatal Intensive Care Unit Resources

“…The key driver to savings in this analysis was less waste of PA, resulting in a significant mean cost-savings per dose of $196.13. Marsh et al 30 performed a similar study comparing the vial sizes, drug waste, and cost savings of PA and BA and also found that vial size was a key cost driver.…”

Pharmacoeconomics of Surfactant Therapy

“…Analyses reveal that the choice of medication could result in cost savings for the institution such as the 20% to 53% reduction in institutional costs for poractant alfa as compared to beractant therapy seen in 1 described study. 12 Surfactant therapy can promote shorter durations of invasive management (i.e., mechanical ventilation). Early extubation and maintenance of CPAP allow for equivalent clinical outcomes with fewer long-term complications compared Pharmacoeconomics of Surfactant Therapy to mechanical ventilation.…”

“…12 This analysis developed 3 cost models to comparatively evaluate the agents using data from 2 published clinical trials comparing poractant alfa and beractant. 13,14 The first 2 models assumed single-dose use of the vials as recommended by the manufacturer.…”