17: Antenatal late preterm steroids: a cost analysis

Abstract

To compare costs of treatment with antenatal corticosteroids versus no treatment for women at risk for late preterm delivery. This is a cost-minimization analysis of a multicenter randomized trial of antenatal corticosteroids versus placebo for women at risk for late preterm delivery. The analysis took a third-party payer approach with a time horizon to first hospital discharge to home. Maternal costs were based on Medicaid rates and included those of the betamethasone (BMZ), as well as the outpatient visits or inpatient stay required to administer the medication (Table). We included all direct medical costs for newborn care. For infants admitted to the NICU, we employed comprehensive daily costs from a similar institution, stratified by the acuity of respiratory illness (ventilator or continuous positive airway pressure (CPAP); Table). For infants admitted to the regular newborn nursery, we used nationally representative estimates from the literature. Maternal and neonatal costs were estimated by treatment assignment, BMZ or placebo and reported in 2015 US$. For this analysis costs were determined from data available for 1425 mother-infant pairs in the BMZ group and 1396 mother-infant pairs in the placebo group. Treatment with BMZ for women at risk for late preterm birth resulted in a total mean cost ($4776.08±$5769.40) that was significantly less than that ($5472.90±$8392.48, p<0.0001) for women who were randomized to placebo (i.e, who did not receive BMZ). Administration of antenatal BMZ to women at risk of late preterm birth significantly decreased health care costs.