In countries with high income, tocolytic therapy with β-mimetic agents is a cost-effective strategy compared to placebo. In our study, the cost-effectiveness of two β-mimetic agents, ritodrine and fenoterol, used in the management of preterm labor was compared in the setting of a low–middle-income transitional country, Serbia Montenegro.
This case study was conducted at the Gynecology-Obstetrics Clinic, Clinical Center “Kragujevac,” in Kragujevac, Serbia primary outcomes of the study were length of pregnancy (in weeks), time passed from the onset of uterine contractions to delivery (in weeks), and score on modified Flanagan's quality-of-life scale for chronic diseases, measured after discharge from hospital.
Prolongation of pregnancy was significantly longer in the fenoterol group (12.7 ± 8.4 weeks) than in the ritodrine group (11.6 ± 7.1 weeks). The mean duration of hospitalization was shorter in the fenoterol group (11.9 ± 8.8 days) than in the ritodrine group (14.9 ± 11.3 days). The treatment with fenoterol was less costly and more cost-effective than the treatment with ritodrine, but the difference in cost-effectiveness was not statistically significant. The cost of treatment per gained week of pregnancy prolongation was 3345.51 ± 7668.04 CSD in the fenoterol group, and 4181.96 ± 12,069.83 CSD in the ritodrine group.
The observed differences in treatment costs and duration of hospitalization per patient did not translate into significant differences in cost-effectiveness ratios, because of low costs of hospitalization and human labor in Serbian health system. Nevertheless, fenoterol treatment still has a tendency to be more cost-effective, and its lower acquisition cost is an advantage to this treatment option.