OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa, Faculty of Medicine, Ottawa, ON, Canada.
Value Health. 2011 Mar-Apr;14(2):240-6. doi: 10.1016/j.jval.2010.10.019. Epub 2011 Feb 5.
The objective of this study was to determine the cost-effectiveness of using transdermal nitroglycerin (GTN) for cases of preterm labor.
The study included 153 women with clinical preterm labor, who were randomly allocated to either a GTN or placebo arm. All randomized cases were included in the final economic analysis. Differences between the two arms in gestational age at delivery, neonatal intensive care unit (NICU) admission, length of NICU stay, and NICU cost were assessed. Costs for non-NICU cases were calculated using Ottawa Hospital data through the Ontario Case Costing Initiative (OCCI). Cost-effectiveness and sensitivity analyses using a hospital perspective were both conducted.
In the 153 randomized cases, 55 babies were admitted to NICU (GTN = 24; placebo = 31). We found no significant differences between the two arms in gestational age at delivery, NICU admission rate (32.4% vs. 39.2%), NICU length of stay (42.7 days vs. 52.8 days), or NICU cost (CAN $34,306 vs. CAN $44,326). Overall, (based on all randomized cases) the cost-effectiveness analyses showed that the GTN arm was the dominant strategy, with both lower cost (CAN $13,397 vs. CAN $18,427) and higher NICU admission avoided rate (67.6% vs. 60.8%) compared to the placebo arm. This dominance persisted in all sensitivity analyses.
The use of GTN patch for preterm labor could reduce NICU costs, while improving important neonatal outcomes.
本研究旨在确定使用经皮硝酸甘油（GTN）治疗早产的成本效益。
本研究纳入了 153 例有临床早产症状的妇女，随机分为 GTN 组或安慰剂组。所有随机分组的病例均纳入最终的经济分析。评估两组在分娩时的胎龄、新生儿重症监护病房（NICU）入院率、NICU 住院时间和 NICU 费用方面的差异。非 NICU 病例的费用使用渥太华医院通过安大略省病例成本核算倡议（OCCI）的数据进行计算。使用医院视角进行了成本效益和敏感性分析。
在 153 例随机分组的病例中，有 55 例婴儿入住 NICU（GTN 组 24 例，安慰剂组 31 例）。我们发现两组在分娩时的胎龄、NICU 入院率（32.4%比 39.2%）、NICU 住院时间（42.7 天比 52.8 天）或 NICU 费用（加元 34306 比加元 44326）方面均无显著差异。总体而言（基于所有随机分组病例），成本效益分析表明 GTN 组是占优策略，具有更低的成本（加元 13397 比加元 18427）和更高的 NICU 入院避免率（67.6%比 60.8%）。这种优势在所有敏感性分析中均持续存在。
使用 GTN 贴片治疗早产可以降低 NICU 成本，同时改善重要的新生儿结局。
