Economic Evaluation of Surfactant Therapy for Neonatal Respiratory Distress Syndrome: 5-Year Real-World Evidence on Poractant Alfa vs. Beractant From the IMSS Perspective in Mexico
Author(s)
José Ángel Paladio-Hernández, MA, MS1, Angélica Hurtado-Vilchis, BA, MS2.
1Head of Health Economics, HealthEcs Consulting, Cuautitlán Izcalli, Mexico, 2CHIESI MEXICO, MEXICO CITY, Mexico.
1Head of Health Economics, HealthEcs Consulting, Cuautitlán Izcalli, Mexico, 2CHIESI MEXICO, MEXICO CITY, Mexico.
OBJECTIVES: In Mexico, neonatal respiratory distress syndrome (RDS) remains a life-threatening complication of prematurity, generating a substantial clinical and economic burden for the Mexican Institute of Social Security (IMSS) through prolonged intensive care, high rates of adverse events, and increased mortality. This study evaluated the long-term cost-effectiveness of Poractant Alpha (Curosurf®, 200 mg/kg) versus Beractant (Survanta®, 100 mg/kg) for the treatment of neonatal RDS, using five-year real-world data from IMSS.
METHODS: Clinical and economic outcomes were assessed in preterm infants treated with Poractant Alpha or Beractant between 2020 and 2024. Patient-level data were extracted from IMSS clinical and administrative databases, including diagnostic codes, treatment records, resource use, and outcomes. The primary outcome was all-cause in-hospital mortality. Secondary outcomes included NICU length of stay, incidence of bronchopulmonary dysplasia (BPD), and persistent ductus arteriosus (PDA). Cost components included surfactant acquisition, NICU hospitalization, and management of complications, all calculated from the IMSS perspective using official tariffs, Diagnosis-Related Groups (DRGs), and standard unit costs. A decision-analytic model (decision tree) was developed to estimate cumulative costs and outcomes over five years. Discounting was not applied due to the nature of the real-world data. Incremental cost-effectiveness ratios (ICERs) were calculated based on avoided mortality. Probabilistic sensitivity analyses using Monte Carlo simulations were conducted to assess uncertainty in inputs and outcomes. All costs are presented in 2025 US dollars.
RESULTS: Poractant Alpha consistently outperformed Beractant, demonstrating lower mortality (8.0% vs. 16.0%), reduced BPD (21.3% vs. 41.5%) and PDA (39.94% vs. 65.07%), shorter NICU stays (33 vs. 41 days), and lower per-patient total costs ($295,147 vs $364,300 USD). These findings were robust under uncertainty in over 95% of simulations.
CONCLUSIONS: Over five years of real-world use within IMSS, Poractant Alpha proved to be a dominant strategy, delivering superior clinical outcomes and greater cost-efficiency in the treatment of neonatal RDS in Mexico’s public healthcare system.
METHODS: Clinical and economic outcomes were assessed in preterm infants treated with Poractant Alpha or Beractant between 2020 and 2024. Patient-level data were extracted from IMSS clinical and administrative databases, including diagnostic codes, treatment records, resource use, and outcomes. The primary outcome was all-cause in-hospital mortality. Secondary outcomes included NICU length of stay, incidence of bronchopulmonary dysplasia (BPD), and persistent ductus arteriosus (PDA). Cost components included surfactant acquisition, NICU hospitalization, and management of complications, all calculated from the IMSS perspective using official tariffs, Diagnosis-Related Groups (DRGs), and standard unit costs. A decision-analytic model (decision tree) was developed to estimate cumulative costs and outcomes over five years. Discounting was not applied due to the nature of the real-world data. Incremental cost-effectiveness ratios (ICERs) were calculated based on avoided mortality. Probabilistic sensitivity analyses using Monte Carlo simulations were conducted to assess uncertainty in inputs and outcomes. All costs are presented in 2025 US dollars.
RESULTS: Poractant Alpha consistently outperformed Beractant, demonstrating lower mortality (8.0% vs. 16.0%), reduced BPD (21.3% vs. 41.5%) and PDA (39.94% vs. 65.07%), shorter NICU stays (33 vs. 41 days), and lower per-patient total costs ($295,147 vs $364,300 USD). These findings were robust under uncertainty in over 95% of simulations.
CONCLUSIONS: Over five years of real-world use within IMSS, Poractant Alpha proved to be a dominant strategy, delivering superior clinical outcomes and greater cost-efficiency in the treatment of neonatal RDS in Mexico’s public healthcare system.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE385
Topic
Clinical Outcomes, Economic Evaluation, Health Technology Assessment
Disease
Pediatrics, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)