The Science Journal of the American Association for Respiratory Care

2005 OPEN FORUM Abstracts

ECONOMIC EFFECTS OF LUCINACTANT (SURFAXIN) AND BERACTANT (SURVANTA®) ON A HOSPITAL'S RESPIRATORY THERAPY DEPARTMENT IN THE PREVENTION OF RESPIRATORY DISTRESS SYNDROME

Amy Grogg, PharmD1; Fernando Moya, MD2; Robert Segal, MD3; Joette M. Gdovin, PhD1; Tejal Vishalpura, PharmD1; Genzhou Liu, PhD3 1Applied Health Outcomes, Palm Harbor, Florida; 2Coastal AHEC, New Hanover Regional Medical Center, Wilmington, North Carolina; 3Discovery Laboratories, Warrington, Pennsylvania

Background: The lungs of pre-term infants with respiratory distress syndrome (RDS) are deficient in pulmonary surfactant. The administration of exogenous surfactant improves oxygenation and reduces neonatal mortality rates among affected infants. A synthetic surfactant containing a mimic of the SP-B protein may reduce the potential risks associated with the use of animal-derived products. Lucinactant (Surfaxin®) is the first available synthetic surfactant containing a peptide (sinapultide; KL4) that mimics human SP-B. Clinical outcomes with lucinactant were shown in clinical trials to be comparable or superior to beractant (Survanta®) (Moya 2005). There are currently no published analyses assessing the economic impact on the department of respiratory therapy of lucinactant compared to beractant.

Methods: A decision-analytic model was developed to assess the pharmacoeconomics of surfactant replacement therapy on a hospital's respiratory therapy department. The objective was to estimate the economic impact of lucinactant compared to beractant in the prevention of RDS among surviving pre-term infants weighing 600 to 1,250 grams on a hospital's respiratory therapy department. Epidemiologic data were from the National Center for Health Statistics (2003), and the Vermont Oxford Network (2004). Clinical outcomes were from the Phase III randomized, controlled clinical trial of lucinactant compared to beractant. Respiratory therapy cost data were from an assessment of daily neonatal intensive care unit (NICU) costs for infants with RDS (2004). Respiratory therapy specific costs included the average cost of daily respiratory therapy for an infant in the NICU on mechanical ventilation (MV) of $329, and of $105 for an infant off MV. Respiratory therapy costs are assumed to occur on each day in the NICU.

Results: Medical costs in the department of respiratory therapy were $10,391 for infants receiving lucinactant and $11,115 for infants receiving beractant. Surviving infants receiving lucinactant had $724 lower costs to a hospital's respiratory therapy department.

Conclusion: The model demonstrates that a hospital that switches from beractant to lucinactant may have lower costs in the department of respiratory therapy for initial NICU hospital stays among surviving infants who receive surfactant therapy.

Budget impact in the department of respiratory therapy for surviving infants receiving surfactant therapy

Cost per infant Lucinactant Beractant
Infants in NICU off mechanical ventilation $6,664.50 $7,214.38
Infants in NICU on mechanical ventilation $3,726.84 $3,900.37
Total respiratory therapy department costs $10,391.34 $11,114.75
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