PIH23 A Discrete Event Simulation Model Used for Pharmacoeconomic Evaluation of Omegaven® in the Chinese Setting

Abstract

To assess clinical efficacy and cost-effectiveness of human recombinant interferon-␣2b in neonates with intrauterine infections in neonatal intensive care unit (NICU). METHODS: We observed 151 neonates (gestational age (GA) 25-40 weeks) with severe intrauterine infections in NICU. Group 1 included 94 neonates with severe intrauterine infections treated with interferon-␣2b, 150 000 IU per suppositorium twice a day per rectum during 7 days in addition to combined antibacterial and supportive therapy; group 2 consisted of 57 neonates under standard treatment without additional immunotherapy. Initially neonates of both groups were comparable. Effectiveness data were used to populate a decision model to estimate the cost-effectiveness of interferon-␣2b and standard therapy. Direct and indirect costs were measured. Published cost data were applied to assess differences in treatment costs. RESULTS: Low mitogen-induced interferon-␣ production (Ͻ12 pg/ml) was detected in 25% [18%; 33%] of neonates with severe intrauterine infections, its association with significantly higher incidence of pneumonia ( Ͻ0.001), necrotizing enterocolitis ( Ͻ0.001) and urinary tract infections ( ϭ0.026) was proved. Administration of human recombinant interferon-␣2b to neonates, suffering from severe infections, provides improvement of mitogen-induced production of interferon-␣, reduces hospital length of stay and mortality rates ( ϭ0.009, OR ϭ 0.21 [0.05; 0.67], RR ϭ 0.26 [0.07; 0.69], NNTϭ8 [4; 29]). Interferon-␣2b administration for severe early-onset neonatal infections decreases direct costs per patient by 20% (direct costs per patient € 6,802 and € 8,549 for interferon-␣2b and control groups, respectively). Interferon-␣2b administration for intrauterine infections leads to substantial cost savings (up to € 69,247 per patient). CONCLUSIONS: Immunotherapy with interferon-␣2b is a cost-effective intervention improves the clinical course and outcome in case of severe intrauterine infections.