OBJECTIVES

To estimate the budget impact of the early rescue surfactant treatment in preterm infants with respiratory distress syndrome (RDS), managed with continuous positive airway pressure (CPAP) therapy, in 2020 in Spain.

METHODS

A decision-analytic model was developed to estimate the resource consumption of early rescue surfactant treatment with less invasive surfactant administration (LISA) techniques, compared to CPAP therapy alone, during the first hospitalization event, from the perspective of the Spanish National Health System. The eligible population were preterm infants (gestational age: 25-32 weeks) with RDS and inspired fraction of oxygen (FiO₂) ≥0.3, requiring respiratory support. Costs were expressed in 2019 euros. The costs of RDS management and treatment of complications (bronchopulmonary dysplasia, severe intraventricular haemorrhage, and air leak syndromes) were considered. The robustness of the model was verified by deterministic and probabilistic sensitivity analyses.

RESULTS

It was estimated that 847 and 2,148 new births were preterm infants with gestational ages of 25-28 and 29-32 weeks, respectively. Early rescue with LISA and CPAP therapy resulted in cost savings for preterm infants with gestational ages of 25-28 weeks (-€1,812,203; probability of cost-saving: 59%), while this therapy had a minimal impact on the management costs of preterm infants with 29-32 weeks (€206,813; probability of cost-saving: 48%). Overall results (preterm infants at 25-32 weeks gestation) showed that 1,605,390€ were expected to be saved with early rescue with LISA. The main component of the total costs was the cost of the management of treatment-related complications, particularly severe intraventricular haemorrhages in preterm infants with a gestational age of 25-28 weeks and air leak syndromes in those aged 29-32 weeks.

CONCLUSIONS

In comparison to CPAP therapy alone, the early rescue therapy with LISA and CPAP results in cost savings in a population of Spanish preterm infants (25-32 weeks gestational age) with RDS and FiO₂≥0.3.