Cost of surfactant replacement treatment for severe neonatal respiratory distress syndrome: a randomised controlled trial.

Tubman, T. R. J.; Halliday, Henry L.; Normand, Charles

doi:10.1136/bmj.301.6756.842

Cited by 66 publications

(21 citation statements)

References 11 publications

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“…Further, Tubman et al showed that if the cost per quality adjusted life year is considered, the surfactant therapy cost much less, compared with other interventions like renal transplantation, coronary bypass and haemodialysis 12 (Table 5). In addition, in some centres, the available ventilators are being utilized 100% while in other centres, these are under-utilized.…”

Section: Miranda Mugford In Her Article In Archives Ofmentioning

confidence: 99%

Enhancing child survival by bridging the gaps in emergency paediatrics

Silva

2013

Sri Lanka J Child Health

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Section: Miranda Mugford In Her Article In Archives Ofmentioning

confidence: 99%

Enhancing child survival by bridging the gaps in emergency paediatrics

Silva

2013

Sri Lanka J Child Health

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“…Several studies have evaluated the cost of treating RDS and the cost effectiveness of surfactant replacement, [16][17][18][19][20][21][22][23][24][25] but the economic consequences of reintubation in preterm infants have not been previously evaluated. The objectives of this study were to estimate the economic impact and health care resource utilization of reintubation and conventional MV strategies in surviving preterm infants weighing 600 to 1250 grams treated with surfactant for the prevention of RDS.…”

Section: Introductionmentioning

confidence: 99%

A Pharmacoeconomic Analysis of In-Hospital Costs Resulting from Reintubation in Preterm Infants Treated with Lucinactant, Beractant, or Poractant Alfa

Guardia

Moya

Sinha

et al. 2012

The Journal of Pediatric Pharmacology and Therapeutics

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OBJECTIVES Reintubation and subsequent mechanical ventilation (MV) in preterm infants after surfactant replacement therapy are associated with excess morbidity and mortality and likely increase in-hospital costs. Specific surfactant therapy selection for prevention of respiratory distress syndrome (RDS) in preterm infants receiving conventional MV may impact not only clinical outcomes but also pharmacoeconomic outcomes. METHODS We conducted a pharmacoeconomic analysis of the impact of surfactant selection and reintubation and subsequent MV of preterm infants on health care resource utilization. Rates of reintubation and duration of MV after reintubation were determined from 1546 preterm infants enrolled in two surfactant trials comparing lucinactant to beractant and poractant alfa. Hospital costs were obtained from a 2010 US database from 1564 preterm infants with RDS, with a direct cost of $2637 per day for MV in the neonatal intensive care unit. Cost of reintubation by study and treatment was estimated as the incidence of reintubation multiplied by days on MV therapy after reintubation multiplied by cost per day for direct MV costs, standardized per 100 surfactant-treated infants. RESULTS There were no differences between studies or treatment groups in the overall extubation rate. Average MV duration following reintubation was similar between groups in both trials; however, reintubation rates were significantly lower (p<0 05) for infants treated with lucinactant than for those receiving beractant or poractant alfa. The observed differences in reintubation rates resulted in a projected cost saving of $160,013 to $252,203 per 100 infants treated with lucinactant versus animal-derived surfactants. CONCLUSIONS In this analysis, higher reintubation rates following successful extubation in preterm infants receiving animal-derived surfactant preparations significantly increased estimated in-hospital costs, primarily due to excess costs associated with MV. This analysis suggests that surfactant selection may have a significant pharmacoeconomic impact on cost of patient care. Additional cost assessment of potential reduction in reintubation-associated morbidity is warranted.

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“…[14][15][16][17][18] Likewise, the pharmacoeconomic impact of surfactant therapy has been evaluated in several studies. 2,[19][20][21][22] When compared to non-treatment (placebo), surfactant has been reported to reduce overall costs, cost per case day, cost per comparable life year, and cost per survivor. 2,[19][20][21][22] These studies present encouraging data which supports the premise that surfactants offer not only significant clinical benefit, but economic value when compared to non-treatment of RDS.…”

Section: Introductionmentioning

confidence: 99%

“…2,[19][20][21][22] When compared to non-treatment (placebo), surfactant has been reported to reduce overall costs, cost per case day, cost per comparable life year, and cost per survivor. 2,[19][20][21][22] These studies present encouraging data which supports the premise that surfactants offer not only significant clinical benefit, but economic value when compared to non-treatment of RDS. Nonetheless, surfactant therapy represents a significant expense for any healthcare institution.…”

Section: Introductionmentioning

confidence: 99%

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

Marsh

Smeeding

York³

et al. 2004

The Journal of Pediatric Pharmacology and Therapeutics

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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.

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Cost of surfactant replacement treatment for severe neonatal respiratory distress syndrome: a randomised controlled trial.

Cited by 66 publications

References 11 publications

Enhancing child survival by bridging the gaps in emergency paediatrics

Enhancing child survival by bridging the gaps in emergency paediatrics

A Pharmacoeconomic Analysis of In-Hospital Costs Resulting from Reintubation in Preterm Infants Treated with Lucinactant, Beractant, or Poractant Alfa

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

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