Drug that Prevents Lung Problems in Older Preterm Babies Also Lowers Costs

March 13, 2019

A new study from researchers at Columbia University Vagelos College of Physicians and Surgeons shows that a drug given to some pregnant women to prevent severe respiratory ailments in preterm newborns reduces health care costs. 

Background

Approximately 7 percent of babies in the United States are born in the late preterm period between 34 and 36 weeks of gestation and are more likely to experience severe respiratory problems than full term babies. Based on the results of a clinical trial, led by a Columbia researcher and published in 2016 in the New England Journal of Medicine, most women at risk for preterm delivery are now given a corticosteroid drug—to speed a baby’s lung development—that reduces the risk of serious respiratory problems in late preterm babies.

“Doctors have widely adopted this preventive strategy for mothers at risk of giving birth prematurely,” says Cynthia Gyamfi-Bannerman, MD, MSc, the Ellen Jacobson Levine and Eugene Jacobson Professor of Obstetrics & Gynecology at Columbia University Vagelos College of Physicians and Surgeons and an obstetrician and maternal-fetal medicine specialist at NewYork-Presbyterian/Columbia University Irving Medical Center, who led the clinical trial. “But we didn’t really know if it was cost-effective.”

What the study found

In the new study, Gyamfi-Bannerman and colleagues tallied the health care costs of the 1,426 mother-infant pairs in the previous clinical trial who had received at least one injection of the drug, betamethasone, and 1,395 pairs from the same study who did not get the drug. Costs were estimated for the drug, respiratory treatments for the newborns, and maternal care, including office visits and hospitalizations within the first 72 hours of birth. 

Cynthia Gyamfi-Bannerman, MD, MSc (CUIMC)

The analysis revealed that pairs who received betamethasone had average costs of $4,681—significantly lower than the $5,379 spent on the pairs who did not get the treatment. Previous studies to determine the cost-effectiveness of this strategy had mixed results, though they did not look at the same outcomes as those in the clinical trial. 

“It’s possible to have an intervention that is highly effective but costly in the end. But based on our analysis, we discovered that corticosteroid therapy for mothers at high risk of late preterm delivery is both highly effective and saves money,” says Gyamfi-Bannerman. 

References

More details

The study is titled “Cost-effectiveness of Antenatal Corticosteroid Therapy vs No Therapy in Women at Risk of Late Preterm Delivery” and was published online March 11 in JAMA Pediatrics.

The other authors are listed in the paper.

The study was supported by the National Heart, Lung, and Blood Institute (HL098554 and HL098354); Eunice Kennedy Shriver National Institute of Child Health and Development (HD21410, HD27915, HD27917, HD27869, HD34116, HD34208, HD40485, HD40500HD40512, HD40544, HD40545, HD40560, HD53097, HD53118, HD68268, HD68258HD68282, and HD36801); the National Institutes of Health (UL1 TR000040); and the Society for Maternal Fetal Medicine.

Gyamfi-Bannerman received an unrestricted grant on prematurity research from AMAG Pharmaceuticals. The authors report no financial or other conflicts of interest.