Real-World Long-Term Clinical and Economic Outcomes of Preterm Infants with Neonatal Respiratory Distress Syndrome in the United States
Author(s)
Alessia Colucciello, MSc1, Natalia Meshchenkova, MD1, Gabriele Vittoria, BA, MASc1, Swapna Munnangi, PhD2, Jenny Tse, MS2, Mitch DeKoven, MHA2, Laura Fabbri, PhD1, Steven Abman, MD3.
1CHIESI FARMACEUTICI S.p.A., Parma, Italy, 2IQVIA, Falls Church, VA, USA, 3University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA.
1CHIESI FARMACEUTICI S.p.A., Parma, Italy, 2IQVIA, Falls Church, VA, USA, 3University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA.
OBJECTIVES: Neonatal respiratory distress syndrome (nRDS) is characterized by pulmonary surfactant deficiency and is a major cause of morbidity in preterm infants. Given the lack of robust evidence on the long-term consequences of nRDS, this study evaluated respiratory outcomes and associated economic implications in a real-world cohort of preterm infants with nRDS in the United States.
METHODS: Preterm infants (gestational age <37 weeks) with nRDS diagnosis (ICD-10-CM P22.0) during the birth hospitalization were identified in IQVIA’s Hospital Charge Data Master (CDM) from October 1, 2015-March 31, 2022. Inclusion criteria comprised linkage to Professional Fee (Dx) and Longitudinal Prescription (LRx) claims in the study period ending March 31, 2024 and key guideline-recommended nRDS treatments (surfactant or continuous positive airway pressure [CPAP]) during the birth hospitalization. Respiratory outcomes (select chronic and acute conditions) and related healthcare resource utilization and costs were described over a minimum 3-month follow-up period post-birth hospitalization discharge.
RESULTS: The cohort included 7,532 preterm infants with nRDS meeting selection criteria (54.0% male; 64.6% in the South; 32.3% were very/extreme preterm, 23.7% were moderate preterm, and 43.6% were late preterm). During the birth hospitalization, 91.5% of patients received CPAP, 29.5% received surfactant, and 34.2% received mechanical ventilation. The mean follow-up duration was 1.3 years, with maximum follow-up of 9 years. During follow-up, 11.3% of patients had asthma (incidence rate per 1,000 person-years [95% CI]: 97.3 [91.9, 103.0], 13.8% had wheeze (199.2 [191.5, 207.2]), and 7.9% had pneumonia (89.7 [84.7, 95.0]). Mean (SD) total respiratory-related healthcare costs were $347 ($5,366) per patient per month, of which 77.5% were inpatient and 9.1% were emergency room (ER) costs. Respiratory-related inpatient and ER visits were observed in 5.5% and 30.8% of patients, respectively.
CONCLUSIONS: Following the birth hospitalization, patients experienced long-term respiratory consequences requiring healthcare visits. Further research on outcomes through adulthood is needed.
METHODS: Preterm infants (gestational age <37 weeks) with nRDS diagnosis (ICD-10-CM P22.0) during the birth hospitalization were identified in IQVIA’s Hospital Charge Data Master (CDM) from October 1, 2015-March 31, 2022. Inclusion criteria comprised linkage to Professional Fee (Dx) and Longitudinal Prescription (LRx) claims in the study period ending March 31, 2024 and key guideline-recommended nRDS treatments (surfactant or continuous positive airway pressure [CPAP]) during the birth hospitalization. Respiratory outcomes (select chronic and acute conditions) and related healthcare resource utilization and costs were described over a minimum 3-month follow-up period post-birth hospitalization discharge.
RESULTS: The cohort included 7,532 preterm infants with nRDS meeting selection criteria (54.0% male; 64.6% in the South; 32.3% were very/extreme preterm, 23.7% were moderate preterm, and 43.6% were late preterm). During the birth hospitalization, 91.5% of patients received CPAP, 29.5% received surfactant, and 34.2% received mechanical ventilation. The mean follow-up duration was 1.3 years, with maximum follow-up of 9 years. During follow-up, 11.3% of patients had asthma (incidence rate per 1,000 person-years [95% CI]: 97.3 [91.9, 103.0], 13.8% had wheeze (199.2 [191.5, 207.2]), and 7.9% had pneumonia (89.7 [84.7, 95.0]). Mean (SD) total respiratory-related healthcare costs were $347 ($5,366) per patient per month, of which 77.5% were inpatient and 9.1% were emergency room (ER) costs. Respiratory-related inpatient and ER visits were observed in 5.5% and 30.8% of patients, respectively.
CONCLUSIONS: Following the birth hospitalization, patients experienced long-term respiratory consequences requiring healthcare visits. Further research on outcomes through adulthood is needed.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE427
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Pediatrics, SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)