Cost-utility of continuous positive airway pressure for respiratory distress in preterm infants in a middle-income country
<p><strong>Objectives: </strong>Despite the increased popularity of continuous positive airway pressure (CPAP) for preterm infants with respiratory distress, there is still uncertainty about whether the additional costs of this device justify the clinical benefits provided...
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| Format: | Journal article |
| Language: | English |
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Elsevier
2023
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| Summary: | <p><strong>Objectives: </strong>Despite the increased popularity of continuous positive airway pressure (CPAP) for preterm infants with respiratory distress, there is still uncertainty about whether the additional costs of this device justify the clinical benefits provided. This study aims to evaluate the cost-utility of CPAP in spontaneously breathing preterm infants with respiratory distress.</p>
<p><strong>Methods: </strong>Using a decision tree model, we estimated the cost and quality-adjusted life-years (QALYs) associated with CPAP and supplemental oxygen alone by headbox or low-flow nasal cannula (SO). The model was analyzed probabilistically, and a value of information analysis was conducted to inform the value of conducting further research to reduce current uncertainties in the evidence base. Cost-effectiveness was evaluated at a willingness-to-pay value of USD5180.</p>
<p><strong>Results: </strong>The mean incremental cost of CPAP versus SO was USD600. The mean incremental benefit of CPAP versus SO was 0.04 QALY. The expected incremental cost per QALY was estimated at USD13 172. The mean incremental net monetary benefit was USD−324 with a 95% credible interval of USD−536 to USD−201. The overall expected value of perfect information per person affected by the decision was estimated to be USD2346.</p>
<p><strong>Conclusions: </strong>Compared with SO, the use of CPAP in spontaneously breathing preterm infants with respiratory distress is not cost-effective in Colombia. Evidence should continue to be generated with real-life effectiveness data and economic evaluations in other countries to confirm our findings.</p> |
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