BIOMAT Database Logo BIOMAT Database Logo

Economic evaluation of caffeine for apnea of prematurity. 2011

Dmitry Dukhovny, and Scott A Lorch, and Barbara Schmidt, and Lex W Doyle, and Joke H Kok, and Robin S Roberts, and Karen L Kamholz, and Na Wang, and Wenyang Mao, and John A F Zupancic, and
Division of Newborn Medicine, Harvard Medical School, Boston, Massachusetts, USA.

OBJECTIVE To determine the cost-effectiveness of treatment with caffeine compared with placebo for apnea of prematurity in infants with birth weights less than 1250 g, from birth through 18 to 21 months' corrected age. METHODS We undertook a retrospective economic evaluation of the cost per survivor without neurodevelopmental impairment by using individual-patient data from the Caffeine for Apnea of Prematurity clinical trial (N = 1869). We included direct medical costs either to the insurance payer or the hospital but excluded costs to parents and society, such as lost productivity. We used a price of $0.21/mg of generic caffeine citrate for our base-case analysis. All costs were expressed in 2008 Canadian dollars and discounted at 3%. The time horizon for this analysis extended through 18 to 21 months' corrected age to match the clinical trial. RESULTS The mean cost per infant was $124 466 in the caffeine group and $133 505 in the placebo group (difference: $9039 [-14 749 to -3375]; adjusted P = .014). Cost-effectiveness analysis showed caffeine to be a dominant or "win-win" therapy: in >99% of 1000 bootstrap replications of the analysis, caffeine-treated infants had simultaneously better outcomes and lower mean costs. These results were robust to a 1000% increase in the individual resource items, including the price of caffeine citrate. CONCLUSIONS In comparison with placebo, caffeine therapy for apnea of prematurity in infants weighing less than 1250 g is economically appealing for infants up to 18 to 21 months' corrected age.

UI MeSH Term Description Entries
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D007235 Infant, Premature, Diseases Diseases that occur in PREMATURE INFANTS.
D008297 Male Males
D002110 Caffeine A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Caffeine's most notable pharmacological effect is as a central nervous system stimulant, increasing alertness and producing agitation. It also relaxes SMOOTH MUSCLE, stimulates CARDIAC MUSCLE, stimulates DIURESIS, and appears to be useful in the treatment of some types of headache. Several cellular actions of caffeine have been observed, but it is not entirely clear how each contributes to its pharmacological profile. Among the most important are inhibition of cyclic nucleotide PHOSPHODIESTERASES, antagonism of ADENOSINE RECEPTORS, and modulation of intracellular calcium handling. 1,3,7-Trimethylxanthine,Caffedrine,Coffeinum N,Coffeinum Purrum,Dexitac,Durvitan,No Doz,Percoffedrinol N,Percutaféine,Quick-Pep,Vivarin,Quick Pep,QuickPep
D003362 Cost-Benefit Analysis A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. In contrast a cost effectiveness in general compares cost with qualitative outcomes. Cost and Benefit,Cost-Benefit Data,Benefits and Costs,Cost Benefit,Cost Benefit Analysis,Cost-Utility Analysis,Costs and Benefits,Economic Evaluation,Marginal Analysis,Analyses, Cost Benefit,Analysis, Cost Benefit,Analysis, Cost-Benefit,Analysis, Cost-Utility,Analysis, Marginal,Benefit and Cost,Cost Benefit Analyses,Cost Benefit Data,Cost Utility Analysis,Cost-Benefit Analyses,Cost-Utility Analyses,Data, Cost-Benefit,Economic Evaluations,Evaluation, Economic,Marginal Analyses
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001049 Apnea A transient absence of spontaneous respiration. Apneas
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective

Related Publications

Dmitry Dukhovny, and Scott A Lorch, and Barbara Schmidt, and Lex W Doyle, and Joke H Kok, and Robin S Roberts, and Karen L Kamholz, and Na Wang, and Wenyang Mao, and John A F Zupancic, and
Caffeine for apnea of prematurity.
August 2006, The New England journal of medicine,
Dmitry Dukhovny, and Scott A Lorch, and Barbara Schmidt, and Lex W Doyle, and Joke H Kok, and Robin S Roberts, and Karen L Kamholz, and Na Wang, and Wenyang Mao, and John A F Zupancic, and
Caffeine for apnea of prematurity.
May 2006, The New England journal of medicine,
Dmitry Dukhovny, and Scott A Lorch, and Barbara Schmidt, and Lex W Doyle, and Joke H Kok, and Robin S Roberts, and Karen L Kamholz, and Na Wang, and Wenyang Mao, and John A F Zupancic, and
Caffeine for apnea of prematurity.
August 2006, The New England journal of medicine,
Dmitry Dukhovny, and Scott A Lorch, and Barbara Schmidt, and Lex W Doyle, and Joke H Kok, and Robin S Roberts, and Karen L Kamholz, and Na Wang, and Wenyang Mao, and John A F Zupancic, and
Caffeine therapy for apnea of prematurity.
May 2006, The New England journal of medicine,
Dmitry Dukhovny, and Scott A Lorch, and Barbara Schmidt, and Lex W Doyle, and Joke H Kok, and Robin S Roberts, and Karen L Kamholz, and Na Wang, and Wenyang Mao, and John A F Zupancic, and
Caffeine citrate therapy for apnea of prematurity.
January 2011, Neonatal network : NN,
Dmitry Dukhovny, and Scott A Lorch, and Barbara Schmidt, and Lex W Doyle, and Joke H Kok, and Robin S Roberts, and Karen L Kamholz, and Na Wang, and Wenyang Mao, and John A F Zupancic, and
An Evaluation of Twice-Daily Dosing of Caffeine for Apnea of Prematurity.
January 2021, The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG,
Dmitry Dukhovny, and Scott A Lorch, and Barbara Schmidt, and Lex W Doyle, and Joke H Kok, and Robin S Roberts, and Karen L Kamholz, and Na Wang, and Wenyang Mao, and John A F Zupancic, and
Apnea of prematurity: theophylline v. caffeine.
January 1992, Alaska medicine,
Dmitry Dukhovny, and Scott A Lorch, and Barbara Schmidt, and Lex W Doyle, and Joke H Kok, and Robin S Roberts, and Karen L Kamholz, and Na Wang, and Wenyang Mao, and John A F Zupancic, and
Apnea of prematurity: caffeine dose optimization.
January 2013, The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG,
Dmitry Dukhovny, and Scott A Lorch, and Barbara Schmidt, and Lex W Doyle, and Joke H Kok, and Robin S Roberts, and Karen L Kamholz, and Na Wang, and Wenyang Mao, and John A F Zupancic, and
Comparison of Caffeine versus Theophylline for apnea of prematurity.
January 2019, Pakistan journal of medical sciences,
Dmitry Dukhovny, and Scott A Lorch, and Barbara Schmidt, and Lex W Doyle, and Joke H Kok, and Robin S Roberts, and Karen L Kamholz, and Na Wang, and Wenyang Mao, and John A F Zupancic, and
Caffeine for apnea of prematurity: a neonatal success story.
January 2014, Neonatology,
Copied contents to your clipboard!