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Cost-effectiveness of prophylactic indomethacin in very-low-birth-weight infants.

Publication ,  Journal Article
Moya, MP; Goldberg, RN
Published in: Ann Pharmacother
February 2002

OBJECTIVE: To perform cost-effectiveness analysis to facilitate the decision-making process surrounding use of indomethacin in preterm infants to lower the incidence of patent ductus arteriosus (PDA), intraventricular hemorrhage (IVH), and death. METHODS: A MEDLINE literature search from 1966 to July 2000 was performed to identify relevant randomized, controlled trials (RCTs), as well as cohort and retrospective case-control studies. A decision tree was built representing the choice to use or not use indomethacin, and the potential outcome costs. Probabilities of being in each chance node were obtained from this search. Where data probabilities were not clear, a sensitivity analysis was conducted. RESULTS: There was no difference in the expected survival per year; however, there was a significant difference when effectiveness was measured as quality-adjusted life years (QALYs), resulting in 11 and 10 years for the indomethacin and control groups, respectively. The indomethacin treatment cost was $95,157 and that of the control groups was $99,955. The cost effectiveness per life expectancy of being in the indomethacin and control groups was $7142 and $7727, respectively. The sensitivity analysis for PDA closure and prevention of IVH for infants eventually developing PDA versus those without PDA showed no difference. The cost-effectiveness analysis per QALY was $8443 for the indomethacin treatment and $9168 for the control group. CONCLUSIONS: The prophylactic use of indomethacin is less costly and more effective within an important range of certainty. However, this analysis does not include several potentially confounding factors, such as antenatal steroid use or indomethacin-induced renal toxicity. Depending on the frequency with which these factors arise, economic projections may be considerably altered against the early use of indomethacin.

Duke Scholars

Published In

Ann Pharmacother

DOI

ISSN

1060-0280

Publication Date

February 2002

Volume

36

Issue

2

Start / End Page

218 / 224

Location

United States

Related Subject Headings

  • Sensitivity and Specificity
  • Retrospective Studies
  • Randomized Controlled Trials as Topic
  • Pharmacology & Pharmacy
  • MEDLINE
  • Infant, Very Low Birth Weight
  • Infant, Newborn
  • Indomethacin
  • Humans
  • Ductus Arteriosus, Patent
 

Citation

APA
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MLA
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Moya, M. P., & Goldberg, R. N. (2002). Cost-effectiveness of prophylactic indomethacin in very-low-birth-weight infants. Ann Pharmacother, 36(2), 218–224. https://doi.org/10.1345/aph.10347
Moya, Martin P., and Ronald N. Goldberg. “Cost-effectiveness of prophylactic indomethacin in very-low-birth-weight infants.Ann Pharmacother 36, no. 2 (February 2002): 218–24. https://doi.org/10.1345/aph.10347.
Moya MP, Goldberg RN. Cost-effectiveness of prophylactic indomethacin in very-low-birth-weight infants. Ann Pharmacother. 2002 Feb;36(2):218–24.
Moya, Martin P., and Ronald N. Goldberg. “Cost-effectiveness of prophylactic indomethacin in very-low-birth-weight infants.Ann Pharmacother, vol. 36, no. 2, Feb. 2002, pp. 218–24. Pubmed, doi:10.1345/aph.10347.
Moya MP, Goldberg RN. Cost-effectiveness of prophylactic indomethacin in very-low-birth-weight infants. Ann Pharmacother. 2002 Feb;36(2):218–224.
Journal cover image

Published In

Ann Pharmacother

DOI

ISSN

1060-0280

Publication Date

February 2002

Volume

36

Issue

2

Start / End Page

218 / 224

Location

United States

Related Subject Headings

  • Sensitivity and Specificity
  • Retrospective Studies
  • Randomized Controlled Trials as Topic
  • Pharmacology & Pharmacy
  • MEDLINE
  • Infant, Very Low Birth Weight
  • Infant, Newborn
  • Indomethacin
  • Humans
  • Ductus Arteriosus, Patent