Economic evaluation of caffeine for apnea of prematurity.
Pediatrics
; 127(1): e146-55, 2011 Jan.
Article
em En
| MEDLINE
| ID: mdl-21173002
ABSTRACT
OBJECTIVE:
To determine the cost-effectiveness of treatment with caffeine compared with placebo for apnea of prematurity in infants with birth weights less than 1250 g, from birth through 18 to 21 months' corrected age.METHODS:
We undertook a retrospective economic evaluation of the cost per survivor without neurodevelopmental impairment by using individual-patient data from the Caffeine for Apnea of Prematurity clinical trial (N = 1869). We included direct medical costs either to the insurance payer or the hospital but excluded costs to parents and society, such as lost productivity. We used a price of $0.21/mg of generic caffeine citrate for our base-case analysis. All costs were expressed in 2008 Canadian dollars and discounted at 3%. The time horizon for this analysis extended through 18 to 21 months' corrected age to match the clinical trial.RESULTS:
The mean cost per infant was $124 466 in the caffeine group and $133 505 in the placebo group (difference $9039 [-14 749 to -3375]; adjusted P = .014). Cost-effectiveness analysis showed caffeine to be a dominant or "win-win" therapy in >99% of 1000 bootstrap replications of the analysis, caffeine-treated infants had simultaneously better outcomes and lower mean costs. These results were robust to a 1000% increase in the individual resource items, including the price of caffeine citrate.CONCLUSIONS:
In comparison with placebo, caffeine therapy for apnea of prematurity in infants weighing less than 1250 g is economically appealing for infants up to 18 to 21 months' corrected age.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Apneia
/
Cafeína
/
Doenças do Prematuro
Tipo de estudo:
Health_economic_evaluation
/
Observational_studies
Limite:
Female
/
Humans
/
Male
/
Newborn
Idioma:
En
Revista:
Pediatrics
Ano de publicação:
2011
Tipo de documento:
Article
País de afiliação:
Estados Unidos