Cargando…
Health Economic Studies of Surfactant Replacement Therapy in Neonates with Respiratory Distress Syndrome: A Systematic Literature Review
BACKGROUND: Neonatal respiratory distress syndrome (RDS) is one of the most common problems for preterm infants, and symptoms include tachypnoea, grunting, retractions and cyanosis, which occur immediately after birth. Treatment with surfactants has reduced morbidity and mortality rates associated w...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10169994/ https://www.ncbi.nlm.nih.gov/pubmed/36906631 http://dx.doi.org/10.1007/s41669-023-00399-x |
_version_ | 1785039149369131008 |
---|---|
author | Magni, Tiziana Ragni, Chiara Pelizzi, Nicola Sharma, Sheetal Perez-Kempner, Lucia Turkstra, Erika Nathani, Jyothsna Orlovic, Martina Meshchenkova, Natalia |
author_facet | Magni, Tiziana Ragni, Chiara Pelizzi, Nicola Sharma, Sheetal Perez-Kempner, Lucia Turkstra, Erika Nathani, Jyothsna Orlovic, Martina Meshchenkova, Natalia |
author_sort | Magni, Tiziana |
collection | PubMed |
description | BACKGROUND: Neonatal respiratory distress syndrome (RDS) is one of the most common problems for preterm infants, and symptoms include tachypnoea, grunting, retractions and cyanosis, which occur immediately after birth. Treatment with surfactants has reduced morbidity and mortality rates associated with neonatal RDS. OBJECTIVE: The objective of this review is to describe the treatment costs, healthcare resource utilization (HCRU) and economic evaluations of surfactant use in the treatment of neonates with RDS. METHODS: A systematic literature review (SLR) was performed to identify available economic evaluations and costs associated with neonatal RDS. Electronic searches were conducted in Embase, MEDLINE, MEDLINE In-Process, NHS EED, DARE and HTAD to identify studies published between 2011 and 2021. Supplementary searches of reference lists, conference proceedings, websites of global health technology assessment bodies and other relevant sources were conducted. Publications were screened by two independent reviewers for inclusion and followed the population, interventions, comparators and outcomes framework eligibility criteria. Quality assessment of the identified studies was performed. RESULTS: Eight publications included in this SLR met all eligibility criteria: three conference abstracts and five peer-reviewed original research articles. Four of these publications evaluated costs/HCRU, and five (three abstracts and two peer-reviewed articles) investigated economic evaluations (two from Russia, and one each from Italy, Spain and England). The main cost drivers and causes of increased HCRU were invasive ventilation, duration of hospitalization and RDS-associated complications. There were no significant differences in neonatal intensive care unit (NICU) length of stay or NICU total costs between infants treated with beractant (Survanta(®)), calfactant (Infasurf(®)) or poractant alfa (Curosurf(®)). However, treatment with poractant alfa was associated with reduced total costs compared with no treatment, continuous positive airway pressure (CPAP) alone or calsurf (Kelisu(®)), due to shorter duration of hospitalization and fewer complications. Early use of the surfactant after birth was more clinically effective and cost-effective than late intervention in infants with RDS. Poractant alfa was found to be cost-effective and cost-saving compared to beractant for the treatment of neonatal RDS in two Russian studies. CONCLUSION: There were no significant differences in NICU length of stay or NICU total costs between surfactants evaluated for treating neonates with RDS. However, early use of surfactant was found to be more clinically effective and cost-effective than late treatment. Treatment with poractant alfa was found to be cost-effective versus beractant and cost-saving compared with CPAP alone or beractant or CPAP in combination with calsurf. Limitations included the small number of studies, the geographic scope of the studies and the retrospective study design of the cost-effectiveness studies. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s41669-023-00399-x. |
format | Online Article Text |
id | pubmed-10169994 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-101699942023-05-11 Health Economic Studies of Surfactant Replacement Therapy in Neonates with Respiratory Distress Syndrome: A Systematic Literature Review Magni, Tiziana Ragni, Chiara Pelizzi, Nicola Sharma, Sheetal Perez-Kempner, Lucia Turkstra, Erika Nathani, Jyothsna Orlovic, Martina Meshchenkova, Natalia Pharmacoecon Open Systematic Review BACKGROUND: Neonatal respiratory distress syndrome (RDS) is one of the most common problems for preterm infants, and symptoms include tachypnoea, grunting, retractions and cyanosis, which occur immediately after birth. Treatment with surfactants has reduced morbidity and mortality rates associated with neonatal RDS. OBJECTIVE: The objective of this review is to describe the treatment costs, healthcare resource utilization (HCRU) and economic evaluations of surfactant use in the treatment of neonates with RDS. METHODS: A systematic literature review (SLR) was performed to identify available economic evaluations and costs associated with neonatal RDS. Electronic searches were conducted in Embase, MEDLINE, MEDLINE In-Process, NHS EED, DARE and HTAD to identify studies published between 2011 and 2021. Supplementary searches of reference lists, conference proceedings, websites of global health technology assessment bodies and other relevant sources were conducted. Publications were screened by two independent reviewers for inclusion and followed the population, interventions, comparators and outcomes framework eligibility criteria. Quality assessment of the identified studies was performed. RESULTS: Eight publications included in this SLR met all eligibility criteria: three conference abstracts and five peer-reviewed original research articles. Four of these publications evaluated costs/HCRU, and five (three abstracts and two peer-reviewed articles) investigated economic evaluations (two from Russia, and one each from Italy, Spain and England). The main cost drivers and causes of increased HCRU were invasive ventilation, duration of hospitalization and RDS-associated complications. There were no significant differences in neonatal intensive care unit (NICU) length of stay or NICU total costs between infants treated with beractant (Survanta(®)), calfactant (Infasurf(®)) or poractant alfa (Curosurf(®)). However, treatment with poractant alfa was associated with reduced total costs compared with no treatment, continuous positive airway pressure (CPAP) alone or calsurf (Kelisu(®)), due to shorter duration of hospitalization and fewer complications. Early use of the surfactant after birth was more clinically effective and cost-effective than late intervention in infants with RDS. Poractant alfa was found to be cost-effective and cost-saving compared to beractant for the treatment of neonatal RDS in two Russian studies. CONCLUSION: There were no significant differences in NICU length of stay or NICU total costs between surfactants evaluated for treating neonates with RDS. However, early use of surfactant was found to be more clinically effective and cost-effective than late treatment. Treatment with poractant alfa was found to be cost-effective versus beractant and cost-saving compared with CPAP alone or beractant or CPAP in combination with calsurf. Limitations included the small number of studies, the geographic scope of the studies and the retrospective study design of the cost-effectiveness studies. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s41669-023-00399-x. Springer International Publishing 2023-03-11 /pmc/articles/PMC10169994/ /pubmed/36906631 http://dx.doi.org/10.1007/s41669-023-00399-x Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc/4.0/Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Systematic Review Magni, Tiziana Ragni, Chiara Pelizzi, Nicola Sharma, Sheetal Perez-Kempner, Lucia Turkstra, Erika Nathani, Jyothsna Orlovic, Martina Meshchenkova, Natalia Health Economic Studies of Surfactant Replacement Therapy in Neonates with Respiratory Distress Syndrome: A Systematic Literature Review |
title | Health Economic Studies of Surfactant Replacement Therapy in Neonates with Respiratory Distress Syndrome: A Systematic Literature Review |
title_full | Health Economic Studies of Surfactant Replacement Therapy in Neonates with Respiratory Distress Syndrome: A Systematic Literature Review |
title_fullStr | Health Economic Studies of Surfactant Replacement Therapy in Neonates with Respiratory Distress Syndrome: A Systematic Literature Review |
title_full_unstemmed | Health Economic Studies of Surfactant Replacement Therapy in Neonates with Respiratory Distress Syndrome: A Systematic Literature Review |
title_short | Health Economic Studies of Surfactant Replacement Therapy in Neonates with Respiratory Distress Syndrome: A Systematic Literature Review |
title_sort | health economic studies of surfactant replacement therapy in neonates with respiratory distress syndrome: a systematic literature review |
topic | Systematic Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10169994/ https://www.ncbi.nlm.nih.gov/pubmed/36906631 http://dx.doi.org/10.1007/s41669-023-00399-x |
work_keys_str_mv | AT magnitiziana healtheconomicstudiesofsurfactantreplacementtherapyinneonateswithrespiratorydistresssyndromeasystematicliteraturereview AT ragnichiara healtheconomicstudiesofsurfactantreplacementtherapyinneonateswithrespiratorydistresssyndromeasystematicliteraturereview AT pelizzinicola healtheconomicstudiesofsurfactantreplacementtherapyinneonateswithrespiratorydistresssyndromeasystematicliteraturereview AT sharmasheetal healtheconomicstudiesofsurfactantreplacementtherapyinneonateswithrespiratorydistresssyndromeasystematicliteraturereview AT perezkempnerlucia healtheconomicstudiesofsurfactantreplacementtherapyinneonateswithrespiratorydistresssyndromeasystematicliteraturereview AT turkstraerika healtheconomicstudiesofsurfactantreplacementtherapyinneonateswithrespiratorydistresssyndromeasystematicliteraturereview AT nathanijyothsna healtheconomicstudiesofsurfactantreplacementtherapyinneonateswithrespiratorydistresssyndromeasystematicliteraturereview AT orlovicmartina healtheconomicstudiesofsurfactantreplacementtherapyinneonateswithrespiratorydistresssyndromeasystematicliteraturereview AT meshchenkovanatalia healtheconomicstudiesofsurfactantreplacementtherapyinneonateswithrespiratorydistresssyndromeasystematicliteraturereview |