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Cost-effectiveness of probiotics for necrotizing enterocolitis prevention in very low birth weight infants
Atoosa F Craighead1,2, Aaron B Caughey3, Anoshua Chaudhuri4
1Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA. AtoosaFCraighead@gmail.com.
Insights
Prophylactic probiotics are a cost-effective strategy for preventing necrotizing enterocolitis (NEC) in very low birth weight (VLBW) infants. This intervention becomes cost-saving at a 6.5% NEC rate, offering significant economic benefits.
Area of Science:
- Neonatal Medicine
- Health Economics
- Preventive Pediatrics
Background:
- Necrotizing enterocolitis (NEC) is a significant cause of morbidity and mortality in very low birth weight (VLBW) infants.
- Prophylactic probiotic administration is a potential strategy to reduce NEC incidence.
Purpose of the Study:
- To evaluate the cost-effectiveness of prophylactic probiotics for NEC prevention in VLBW infants.
- To determine the economic impact and optimal conditions for probiotic intervention.
Main Methods:
- A decision-analytic model was developed using TreeAge software.
- Effectiveness was measured in quality-adjusted life-years (QALYs).
- Cost-effectiveness was assessed via incremental cost-effectiveness ratio (ICER) and sensitivity analyses (SA).
Main Results:
- The base case analysis yielded an ICER of $1868 per QALY gained for probiotics versus no probiotics.
- Sensitivity analyses indicated that probiotics become cost-saving at NEC rates of 6.5% or higher.
- Probiotics were also cost-saving with incremental NEC costs of $37,500 or higher.
Conclusions:
- Prophylactic probiotics represent a cost-effective strategy for reducing NEC in VLBW infants.
- Sensitivity analyses confirm the model's adaptability to different clinical settings.
- This economic evaluation supports the integration of probiotics into clinical practice for NEC prevention.
Objective:
To examine the cost-effectiveness of prophylactic probiotics on necrotizing enterocolitis (NEC) prevention in very low birth weight (VLBW) infants.
Study Design:
We built a decision-analytic model using TreeAge. Effectiveness was assessed using quality-adjusted life-years (QALY). Primary outcome was an incremental cost-effectiveness ratio (ICER) expressed as cost per QALY gained. Costs were expressed in 2017 US dollars. Deterministic and probabilistic sensitivity analyses (SA) were performed.
Results:
For the base case analysis, the ICER of probiotics versus no probiotics for the prevention of NEC in VLBW infants was $1868/QALY. SA revealed that probiotics became cost-saving at a NEC rate of 6.5% and higher or with incremental NEC cost of $37,500 or higher.
Conclusions:
Our model demonstrated that prophylactic probiotics were a cost-effective strategy in NEC reduction. SA confirmed that the model is customizable to various clinical settings and thus, can aid in understanding the economic impact of this intervention.
