McBride J A, Parad R B, Davis J M, Zheng Z, Zupancic J A F
Division of Newborn Medicine, Harvard Medical School, Boston, MA, USA.
J Perinatol. 2009 May;29(5):364-71. doi: 10.1038/jp.2008.225. Epub 2009 Feb 19.
To determine the cost-effectiveness of recombinant human superoxide dismutase (rhSOD) in the prevention of chronic respiratory morbidity, defined as use of respiratory medications, in preterm infants.
This retrospective economic evaluation was undertaken using data from a previously published randomized controlled trial of the use of rhSOD in neonates of birthweight 600 to 1200 g. This ancillary study measured all relevant direct medical costs from birth to 1 year corrected age using resource data collected for infants from the clinical trial. Unit costs were derived from secondary datasets in similar populations, stratified by level of care or diagnosis. All costs were expressed in 2003 US dollars.
rhSOD was associated with a highly favorable incremental cost of only $378 per chronic respiratory morbidity averted at 1 year corrected age. There was a 95% probability that the therapy would be considered cost-effective if a decision maker was willing to pay $7000 to avert one infant with long-term significant respiratory illness, and a 52% probability that it would actually reduce costs while improving outcomes. These results were more pronounced among infants <27 weeks gestational age at birth.
Based on resource data from a single randomized trial, this retrospective analysis supports the potential economic desirability of rhSOD treatment in this population.
确定重组人超氧化物歧化酶(rhSOD)预防早产儿慢性呼吸系统疾病(定义为使用呼吸药物)的成本效益。
本回顾性经济评估使用了先前发表的一项关于rhSOD用于出生体重600至1200克新生儿的随机对照试验的数据。这项辅助研究使用从临床试验中收集的婴儿资源数据,测量了从出生到1岁矫正年龄的所有相关直接医疗成本。单位成本来自类似人群的二级数据集,按护理水平或诊断分层。所有成本均以2003年美元表示。
rhSOD与非常有利的增量成本相关,在1岁矫正年龄时,每避免一例慢性呼吸系统疾病的增量成本仅为378美元。如果决策者愿意支付7000美元以避免一名患有长期严重呼吸系统疾病的婴儿,那么该治疗被认为具有成本效益的概率为95%,而实际上在改善结局的同时降低成本的概率为52%。这些结果在出生时胎龄小于27周的婴儿中更为明显。
基于一项单一随机试验的资源数据,这项回顾性分析支持了rhSOD治疗该人群的潜在经济合理性。