PIH6 Economic Evaluation of the Automated Resuscitator Device for Asphyxiated Neonates in Tertiary LEVEL Healthcare Setting in India

Abstract

To calculate the Cost-Effectiveness of the Automated Resuscitator Device (ARD) vis-a-vis the present standard of care Self Inflating Bag. We compare the cost of both the interventions from a societal perspective, and the used Disability Adjusted Life Years to measure the economic burden. This we calculated the Incremental cost effectiveness ratio of the new intervention and check for its robustness through one way and probabilistic sensitivity analysis. We built a de-novo mathematical decision model will be built to assess the comparative cost- effectiveness of Automated Resuscitation Device versus Self-inflating bag. The intervention (ARD) for birth asphyxiated new-borns requiring resuscitation in Public health care settings was compared to the current standard of care (self inflating bags) for outcomes such as long term morbidity and mortality. The follow-up time for the study was 28 days. The Incremental Cost Effectiveness ratio (ICER) for the new device when compared to self-inflating bag is -(1443.16) Rs/DALY averted. The negative ICER value implies that the new device is both clinically and cost effective compared to the standard of care. In order to check the robustness of these results, we ran Monte carlo simulations and found that new device would be cost-effective with 95% probability at Rs 1,250/-. Based on the Incremental Cost Effectiveness ratio value we obtained, the ARD device reduces both the cost and averts Disability adjusted life years by the virtue of reducing the number of severe cases caused due to birth asphyxia. Based on this analysis, the device can be used at a tertiary level healthcare setting with centralized oxygen supply and preferably with an air oxygen blender and pulse oximeter for this device.