Cost-effectiveness of ritodrine and fenoterol for treatment of preterm labor in a low-middle-income country : a case study
(2008) In Value in Health 11(2). p.53-149- Abstract
OBJECTIVES: In countries with high income, tocolytic therapy with beta-mimetic agents is a cost-effective strategy compared to placebo. In our study, the cost-effectiveness of two beta-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.
METHODS: This case study was conducted at the Gynecology-Obstetrics Clinic, Clinical Center "Kragujevac," in Kragujevac, Serbia & Montenegro, between October 2004 and January 2006. In total, 235 pregnant patients with threatened preterm labor were enrolled, but 35 were lost to follow-up. Of the remaining 200 patients, 85 were given ritodrine, and 115 fenoterol. The... (More)
OBJECTIVES: In countries with high income, tocolytic therapy with beta-mimetic agents is a cost-effective strategy compared to placebo. In our study, the cost-effectiveness of two beta-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.
METHODS: This case study was conducted at the Gynecology-Obstetrics Clinic, Clinical Center "Kragujevac," in Kragujevac, Serbia & Montenegro, between October 2004 and January 2006. In total, 235 pregnant patients with threatened preterm labor were enrolled, but 35 were lost to follow-up. Of the remaining 200 patients, 85 were given ritodrine, and 115 fenoterol. The perspective of Republic Institute for Health Insurance in Serbia was taken into account. Only direct costs were calculated; 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.
RESULTS: 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.
CONCLUSIONS: 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.
(Less)
- author
- Jakovljevic, Mihajlo LU ; Varjacic, Mirjana and Jankovic, Slobodan M
- publishing date
- 2008-04-03
- type
- Contribution to journal
- publication status
- published
- keywords
- Adult, Cohort Studies, Cost-Benefit Analysis/economics, Female, Fenoterol/economics, Hospitals, University/statistics & numerical data, Humans, Montenegro, National Health Programs, Obstetric Labor, Premature/drug therapy, Pregnancy, Ritodrine/economics, Social Class, Tocolytic Agents/economics, Treatment Outcome, Yugoslavia
- in
- Value in Health
- volume
- 11
- issue
- 2
- pages
- 53 - 149
- publisher
- Wiley-Blackwell
- external identifiers
-
- scopus:41549153771
- pmid:18380627
- ISSN
- 1098-3015
- DOI
- 10.1111/j.1524-4733.2007.00222.x
- language
- English
- LU publication?
- no
- id
- 0456dbc2-961c-4acd-9939-d603b8209c70
- date added to LUP
- 2018-09-01 23:11:52
- date last changed
- 2024-01-15 00:49:52
@article{0456dbc2-961c-4acd-9939-d603b8209c70,
abstract = {{<p>OBJECTIVES: In countries with high income, tocolytic therapy with beta-mimetic agents is a cost-effective strategy compared to placebo. In our study, the cost-effectiveness of two beta-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.</p><p>METHODS: This case study was conducted at the Gynecology-Obstetrics Clinic, Clinical Center "Kragujevac," in Kragujevac, Serbia & Montenegro, between October 2004 and January 2006. In total, 235 pregnant patients with threatened preterm labor were enrolled, but 35 were lost to follow-up. Of the remaining 200 patients, 85 were given ritodrine, and 115 fenoterol. The perspective of Republic Institute for Health Insurance in Serbia was taken into account. Only direct costs were calculated; 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.</p><p>RESULTS: 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.</p><p>CONCLUSIONS: 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.</p>}},
author = {{Jakovljevic, Mihajlo and Varjacic, Mirjana and Jankovic, Slobodan M}},
issn = {{1098-3015}},
keywords = {{Adult; Cohort Studies; Cost-Benefit Analysis/economics; Female; Fenoterol/economics; Hospitals, University/statistics & numerical data; Humans; Montenegro; National Health Programs; Obstetric Labor, Premature/drug therapy; Pregnancy; Ritodrine/economics; Social Class; Tocolytic Agents/economics; Treatment Outcome; Yugoslavia}},
language = {{eng}},
month = {{04}},
number = {{2}},
pages = {{53--149}},
publisher = {{Wiley-Blackwell}},
series = {{Value in Health}},
title = {{Cost-effectiveness of ritodrine and fenoterol for treatment of preterm labor in a low-middle-income country : a case study}},
url = {{http://dx.doi.org/10.1111/j.1524-4733.2007.00222.x}},
doi = {{10.1111/j.1524-4733.2007.00222.x}},
volume = {{11}},
year = {{2008}},
}