Cost-effectiveness analysis of a low-cost bubble CPAP device in providing ventilatory support for neonates in Malawi - a preliminary report

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dc.citation.firstpage288en_US
dc.citation.journalTitleBMC Pediatricsen_US
dc.citation.volumeNumber14en_US
dc.contributor.authorChen, Arielen_US
dc.contributor.authorDeshmukh, Ashish A.en_US
dc.contributor.authorRichards-Kortum, Rebeccaen_US
dc.contributor.authorMolyneux, Elizabethen_US
dc.contributor.authorKawaza, Kondwanien_US
dc.contributor.authorCantor, Scott B.en_US
dc.contributor.orgInstitute for Global Health Technologiesen_US
dc.date.accessioned2014-12-01T17:26:01Zen_US
dc.date.available2014-12-01T17:26:01Zen_US
dc.date.issued2014en_US
dc.description.abstractA low-cost bubble continuous positive airway pressure (bCPAP) device has been shown to be an excellent clinical alternative to nasal oxygen for the care of neonates with respiratory difficulty. However, the delivery of bCPAP requires more resources than the current routine care using nasal oxygen. We performed an economic evaluation to determine the cost-effectiveness of a low-cost bCPAP device in providing ventilatory support for neonates in Malawi. We used patient-level clinical data from a previously published non-randomized controlled study. Economic data were based on the purchase price of supplies and equipment, adjusted for shelf life, as well as hospital cost data from the World Health Organization. Costs and benefits were discounted at 3%. The outcomes were measured in terms of cost, discounted life expectancy, cost/life year gained and net benefits of using bCPAP or nasal oxygen. The incremental cost-effectiveness ratio and incremental net benefits determined the value of one intervention compared to the other. Subgroup analysis on several parameters (birth weight categories, diagnosis of respiratory distress syndrome, and comorbidity of sepsis) was conducted to evaluate the effect of these parameters on the cost-effectiveness. Nasal oxygen therapy was less costly (US$29.29) than the low-cost bCPAP device ($57.78). Incremental effectiveness associated with bCPAP was 6.78 life years (LYs). In the base case analysis, the incremental cost-effectiveness ratio for bCPAP relative to nasal oxygen therapy was determined to be $4.20 (95% confidence interval, US$2.29–US$16.67) per LY gained. The results were highly sensitive for all tested subgroups, particularly for neonates with birth weight 1– < 1.5 kg, respiratory distress syndrome, or comorbidity of sepsis; these subgroups had a higher probability that bCPAP would be cost effective. The bCPAP is a highly cost-effective strategy in providing ventilatory support for neonates in Malawi.en_US
dc.identifier.citationChen, Ariel, Deshmukh, Ashish A., Richards-Kortum, Rebecca, et al.. "Cost-effectiveness analysis of a low-cost bubble CPAP device in providing ventilatory support for neonates in Malawi - a preliminary report." <i>BMC Pediatrics,</i> 14, (2014) BioMed Central: 288. http://dx.doi.org/10.1186/s12887-014-0288-1.en_US
dc.identifier.doihttp://dx.doi.org/10.1186/s12887-014-0288-1en_US
dc.identifier.urihttps://hdl.handle.net/1911/78533en_US
dc.language.isoengen_US
dc.publisherBioMed Centralen_US
dc.rightsThis article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.en_US
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/en_US
dc.subject.keywordcost-effectiveness analysisen_US
dc.subject.keywordneonateen_US
dc.subject.keywordMalawien_US
dc.subject.keywordprematurityen_US
dc.subject.keywordrespiratory distress syndromeen_US
dc.subject.keywordsepsisen_US
dc.subject.keywordventilatory supporten_US
dc.subject.keywordbubble continuous positive airway pressureen_US
dc.titleCost-effectiveness analysis of a low-cost bubble CPAP device in providing ventilatory support for neonates in Malawi - a preliminary reporten_US
dc.typeJournal articleen_US
dc.type.dcmiTexten_US
dc.type.publicationpublisher versionen_US
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