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Cost-Utility of Continuous Positive Airway Pressure for Respiratory Distress in Preterm Infants in a Middle-Income

Jefferson Antonio Buendía1, Ricardo Hernández-Sarmiento2, Jorge Enrique Rojas Medina3

  • 1Research group in Pharmacology and Toxicology "INFARTO," Department of Pharmacology and Toxicology, University of Antioquia, Medellín, Colombia; Department of Pediatrics and Intensive Care, Fundación Cardioinfantil-Instituto de Cardiología, Universidad de la Sabana, Bogotá, Colombia.

Value in Health Regional Issues
|January 19, 2023
PubMed

Insights

Continuous positive airway pressure (CPAP) is not cost-effective for preterm infants with respiratory distress in Colombia. Further research is needed to confirm these findings on CPAP

Area of Science:

  • Neonatal Medicine
  • Health Economics
  • Clinical Research

Background:

  • Continuous positive airway pressure (CPAP) is increasingly used for respiratory distress in preterm infants.
  • Uncertainty exists regarding the cost-effectiveness of CPAP compared to standard care.
  • This study evaluates the economic value of CPAP in this population.

Purpose of the Study:

  • To assess the cost-utility of CPAP versus supplemental oxygen (SO) in spontaneously breathing preterm infants with respiratory distress.
  • To determine if the clinical benefits of CPAP justify its additional costs.
  • To inform healthcare decision-making regarding CPAP implementation.

Main Methods:

  • A decision tree model was employed to estimate costs and quality-adjusted life-years (QALYs).
  • Probabilistic analysis and value of information analysis were conducted.
  • Cost-effectiveness was evaluated against a willingness-to-pay threshold of US$5180.

Main Results:

  • CPAP incurred an incremental cost of US$600 and provided an incremental benefit of 0.04 QALY compared to SO.
  • The estimated incremental cost per QALY was US$13,172.
  • The incremental net monetary benefit was negative (US$-324), indicating CPAP was not cost-effective.

Conclusions:

  • CPAP is not a cost-effective intervention for preterm infants with respiratory distress in Colombia when compared to SO.
  • Further real-world effectiveness data and economic evaluations in diverse settings are recommended.
  • The findings suggest a need for continued evidence generation to guide CPAP use in neonatal care.
Abstract

Keywords:
CPAPhealth economicshealthcareoxygenpublic health

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