A Pharmacoeconomic Analysis of In-Hospital Costs Resulting from Reintubation in Preterm Infants Treated with Lucinactant, Beractant, or Poractant Alfa
| Autor: | Sunil K. Sinha, Robert Segal, Fernando Moya, Phillip D. Simmons, Carlos Guardia, Jay S. Greenspan |
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| Rok vydání: | 2012 |
| Předmět: |
Mechanical ventilation
Pediatrics medicine.medical_specialty Neonatal intensive care unit Respiratory distress business.industry Lucinactant medicine.medical_treatment Direct cost Surfactant therapy Pediatrics Perinatology and Child Health Medicine Poractant alfa Pharmacology (medical) Clinical Investigation business Beractant medicine.drug |
| Zdroj: | The Journal of Pediatric Pharmacology and Therapeutics. 17:220-227 |
| ISSN: | 1551-6776 |
| DOI: | 10.5863/1551-6776-17.3.220 |
| Popis: | OBJECTIVESReintubation 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.METHODSWe 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.RESULTSThere 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 (pCONCLUSIONSIn 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. |
| Databáze: | OpenAIRE |
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