A Comparison of the Cost of Treatment with Atosiban orbeta-Sympatomimetic Drugs in Premature Delivery from thePerspective of Health Care Payer – a Pharmaco-Economic Model

Overview

Objective:
To evaluate the cost of treating premature delivery with atosiban or beta-sympatomimeticdrugs (fenoterol and hexoprenalin) from the perspective of health care payer – the medicalinsurance company.Design: A pharmaco-economic model based on the results of randomized, controlled clinical study.Setting: Hospital Pharmacy at Vítkovice Hospital of Blessed Mary Antonia, Ostrava.Methods: The study is based on the application of clinical decision-making analysis, which includesresults of a randomized controlled clinical study as well as data on the cost of clinicalinterventions and cost of drug therapy. The pharmaco-economic model was created from the perspectiveof the payer of health care – the insurance company. This model presumes the administrationof atosiban or beta-sympatomimetic drugs (fenoterol and hexoprenalin) for the period of18 and 48 h and the therapy of possible untoward effects for the next 72 h after the administrationof the drugs. The analysis of sensitivity of pharmacokinetic model also employs so called low andhigh estimate of supplementary cost for the treatment of untoward effects.Results: After the administration of the drugs for the period of 18 h the total cost of the payerof medical care was in the range of 21 914.5 - 21 974.4 CKr in atosiban, 19 878.7 - 22 661.4 CKr infenoterol and 19 942.9 - 21 974.4 CKr in hexoprenalin. In the administration of the drugs for 48 h,the overall cost of the payer of medical care was in the range of 43 082.5 - 43 142.4 CKr in atosiban,19 960.3 - 23 150.7 CKr in fenoterol and 20 131.3 - 23 574.0 in hexoprenalin.Conclusions: This study compared overall cost associated with hospitalization of a prematuredelivery from the perspective of the medical care payer, i.e. the health insurance company. Theauthors applied a pharmaco-economic model evaluating hospitalization for the period of 48h and subsequent therapy of possible untoward effects for the period of up to 72 h. In case ofa shorter administration of atosiban (up to 18 h) the overall cost of hospitalization for prematuredelivery for the period of 48 h from the point of view of medical insurance company is basicallycomparable with the administration of beta-sympatomimetic drugs. If atosiban is administeredfor more than 18 h, the overall cost of hospitalization is higher than with beta-sympatomimeticdrugs, and the cost increases in relation to the duration of atosiban administration.

Key words:
premature delivery, toxolytic drugs, atosiban, pharmaco-economy