Prospective economic evaluation alongside the non-invasive ventilation trial

J Perinatol. 2017 Jan;37(1):61-66. doi: 10.1038/jp.2016.159. Epub 2016 Sep 29.

Abstract

Objective: To determine the cost-effectiveness of nasal continuous positive pressure (nCPAP) compared with nasal intermittent positive pressure ventilation (NIPPV) in the context of the reported randomized clinical trial.

Study design: Using patient-level data from the clinical trial, we undertook a prospectively planned economic evaluation. We measured costs, from a third-party payer perspective in all patients, and from a societal perspective in a subgroup with a time horizon through the earlier of discharge, death or 44 weeks post-menstrual age.

Results: From the third-party payer perspective, the mean cost of hospitalization per infant was statistically similar, $143 745 in the NIPPV group compared to $140 403 in the nCPAP group. Cost-effectiveness evaluation revealed a 61% probability that NIPPV is more expensive and less effective than nCPAP. Similar results were found in subgroup analysis from a societal perspective.

Conclusion: In addition to being clinically equivalent, economic evaluation confirms that NIPPV, as employed in this trial, is also not economically favorable.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Continuous Positive Airway Pressure / economics*
  • Continuous Positive Airway Pressure / methods
  • Cost-Benefit Analysis / statistics & numerical data*
  • Female
  • Gestational Age
  • Health Care Costs / statistics & numerical data*
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Intensive Care Units, Neonatal / economics
  • Intermittent Positive-Pressure Ventilation / economics*
  • Intermittent Positive-Pressure Ventilation / methods
  • Male
  • Noninvasive Ventilation / methods
  • Prospective Studies
  • Respiratory Distress Syndrome, Newborn / therapy
  • Sensitivity and Specificity