COST-EFFECTIVENESS AND BUDGET IMPACT OF CAFFEINE CITRATE VERSUS AMINOPHYLLINE FOR APNEA OF PREMATURITY ACROSS A PUBLIC HEALTHCARE SYSTEM IN MEXICO
Author(s)
José Ángel Paladio-Hernández, MA, MS1, Angélica Hurtado-Vilchis, BA, MS2, Raquel Díaz-Rojas, MBA3, Madai Deolarte, MA4.
1Head of Health Economics, PalaGod Health Supply, Mexico City, Mexico, 2CHIESI MEXICO, MEXICO CITY, Mexico, 3Chiesi México, Mexico City, Mexico, 4CHIESI México, Mexico City, Mexico.
1Head of Health Economics, PalaGod Health Supply, Mexico City, Mexico, 2CHIESI MEXICO, MEXICO CITY, Mexico, 3Chiesi México, Mexico City, Mexico, 4CHIESI México, Mexico City, Mexico.
OBJECTIVES: Apnea of prematurity is a frequent complication among preterm neonates and is associated with increased morbidity, prolonged neonatal intensive care unit stay, and high healthcare resource utilization. This study evaluates the cost-effectiveness and budget impact of Peyona® (caffeine citrate; CC) compared with aminophylline for the treatment of apnea of prematurity from the perspective of the ISSSTE in Mexico.
METHODS: A cost-effectiveness analysis combined with a budget impact analysis was conducted from the institutional perspective of ISSSTE. Clinical effectiveness in apnea control was assumed to be comparable between treatment alternatives, while economic differences were driven by variations in comorbidity-related resource utilization. CC was assumed to prevent 95% of comorbidities associated with apnea of prematurity compared with aminophylline, resulting in reduced downstream healthcare utilization. Total per-patient costs were estimated at USD 5,508 for CC and USD 6,152.44 for aminophylline. Comorbidity-related costs accounted for 81.66% of total costs with CC and 99.6% with aminophylline. The budget impact analysis was performed over a three-year time horizon assuming progressive adoption of CC. All costs are expressed in 2026 US dollars.
RESULTS: CC was associated with lower total per-patient costs, generating savings of USD 644.44 per treated patient compared with aminophylline. These savings were primarily driven by the prevention of comorbidity-related events, with CC avoiding 95% of comorbidities relative to aminophylline, leading to a substantial reduction in complication-related costs. Within the cost-effectiveness framework, CC was identified as a dominant strategy, offering comparable effectiveness at a lower overall cost. Over the three-year horizon, increasing adoption of CC resulted in cumulative budget savings for ISSSTE, with total savings directly proportional to the substitution rate and number of treated neonates.
CONCLUSIONS: CC represents a cost-effective and cost-saving alternative to aminophylline for the management of apnea of prematurity within ISSSTE, supporting efficient resource allocation and long-term economic sustainability of neonatal care programs.
METHODS: A cost-effectiveness analysis combined with a budget impact analysis was conducted from the institutional perspective of ISSSTE. Clinical effectiveness in apnea control was assumed to be comparable between treatment alternatives, while economic differences were driven by variations in comorbidity-related resource utilization. CC was assumed to prevent 95% of comorbidities associated with apnea of prematurity compared with aminophylline, resulting in reduced downstream healthcare utilization. Total per-patient costs were estimated at USD 5,508 for CC and USD 6,152.44 for aminophylline. Comorbidity-related costs accounted for 81.66% of total costs with CC and 99.6% with aminophylline. The budget impact analysis was performed over a three-year time horizon assuming progressive adoption of CC. All costs are expressed in 2026 US dollars.
RESULTS: CC was associated with lower total per-patient costs, generating savings of USD 644.44 per treated patient compared with aminophylline. These savings were primarily driven by the prevention of comorbidity-related events, with CC avoiding 95% of comorbidities relative to aminophylline, leading to a substantial reduction in complication-related costs. Within the cost-effectiveness framework, CC was identified as a dominant strategy, offering comparable effectiveness at a lower overall cost. Over the three-year horizon, increasing adoption of CC resulted in cumulative budget savings for ISSSTE, with total savings directly proportional to the substitution rate and number of treated neonates.
CONCLUSIONS: CC represents a cost-effective and cost-saving alternative to aminophylline for the management of apnea of prematurity within ISSSTE, supporting efficient resource allocation and long-term economic sustainability of neonatal care programs.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE63
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis, Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Pediatrics