Economic evaluation of recombinant human copper zinc superoxide dismutase administered at birth to premature infants

Abstract

To determine the cost-effectiveness of recombinant human superoxide dismutase (rhSOD) in the prevention of chronic respiratory morbidity, defined as use of respiratory medications, in preterm infants. This retrospective economic evaluation was undertaken using data from a previously published randomized controlled trial of the use of rhSOD in neonates of birthweight 600 to 1200 g. This ancillary study measured all relevant direct medical costs from birth to 1 year corrected age using resource data collected for infants from the clinical trial. Unit costs were derived from secondary datasets in similar populations, stratified by level of care or diagnosis. All costs were expressed in 2003 US dollars. rhSOD was associated with a highly favorable incremental cost of only $378 per chronic respiratory morbidity averted at 1 year corrected age. There was a 95% probability that the therapy would be considered cost-effective if a decision maker was willing to pay $7000 to avert one infant with long-term significant respiratory illness, and a 52% probability that it would actually reduce costs while improving outcomes. These results were more pronounced among infants <27 weeks gestational age at birth. Based on resource data from a single randomized trial, this retrospective analysis supports the potential economic desirability of rhSOD treatment in this population.