Mugford Miranda
School of Medicine Health Policy and Practice, University of East Anglia, Norwich NR4 7TJ, UK.
Early Hum Dev. 2006 Feb;82(2):105-15. doi: 10.1016/j.earlhumdev.2006.01.005. Epub 2006 Feb 7.
In 1993, exogenous surfactant products were emerging as licensed treatments for respiratory distress syndrome (RDS), a leading cause of death in preterm newborn babies. Models of cost-effectiveness of alternative treatments showed surfactant to be an expensive but effective and also cost effective treatment. However the most efficient policy for use of surfactant depended on other parallel 'technologies' such as giving antenatal corticosteroids where preterm delivery is anticipated. Following introduction into clinical practice, questions changed from whether to use surfactant, to when, and which product to use. The early models of cost effectiveness were dependent on the neonatal technology in use, and on the costs of neonatal care and prices of surfactant at the time. Little information was available about long term outcomes. The aims of this paper are to summarise the role of surfactant in the economics of newborn care since the late 1980s; to observe the value of studies published in the early 1990s for current decisions; and to comment on recent and possible future economic studies of neonatal surfactant.
1993年，外源性表面活性剂产品开始成为治疗呼吸窘迫综合征（RDS）的许可疗法，呼吸窘迫综合征是早产新生儿死亡的主要原因。替代疗法的成本效益模型表明，表面活性剂是一种昂贵但有效且具有成本效益的治疗方法。然而，使用表面活性剂的最有效策略取决于其他并行的“技术”，例如在预期早产时给予产前皮质类固醇。在引入临床实践后，问题从是否使用表面活性剂转变为何时使用以及使用哪种产品。早期的成本效益模型取决于当时使用的新生儿技术、新生儿护理成本和表面活性剂价格。关于长期结果的信息很少。本文的目的是总结自20世纪80年代末以来表面活性剂在新生儿护理经济学中的作用；观察20世纪90年代初发表的研究对当前决策的价值；并对新生儿表面活性剂的近期和未来可能的经济学研究发表评论。
