Caffeine citrate: clinical and economic aspects in extremely low birth weight and very low birth weight infants

• Oksana I. Ivakhnenko
• Victor V. Zubkov

Abstract

Objective of the study. To evaluate the cost-effectiveness of caffeine citrate for the prevention and treatment of apnea in extremely low birth weight (ELBW) and very low birth weight (VLBW) infants.

Material and methods. The study has been performed using a mathematical model. The decision tree model was applied for alternative medical care scenarios. The study considered direct medical costs.

Results. According to the estimated data, the number of premature infants with ELBV and VLBV was 7700 patients and including 1900 infants with cerebral palsy (CP) in 2023. It is anticipated that the utilisation of caffeine citrate for the treatment of apnea of prematurity will result in a reduction of CP by 42% (1100 cases). The incremental cost-effectiveness ratio (ICER) per case of CP prevented was 230 145.17 rubles. When the cost of a routine rehabilitation program for premature infants with CP was 250 377.78 rubles (RUR) per year. By reducing the number of CP cases, we will save on the rehabilitation program in the amount of 0.278 billion RUR in one year. The utilisation of caffeine citrate has no influence on the alteration of the healthcare system budget in terms of the costs of providing medical care for premature infants with ELBW and VLBW. In regard to the target population, the discrepancy in costs between the current and anticipated practice was RUR 0.255 billion (+4.90%), which represents of 8.08% reduction in the costs of the rehabilitation program. The increase in drug costs in the tariff structure is compensated not only by a reduction in direct medical costs for rehabilitation activities, but also by a reduction in the costs of performing ventilation, including amortisation and maintenance of equipment.

Keywords: caffeine citrate; clinical and economic evaluation; preterm labour; extremely low birth weight; preterm newborns; apnoea of prematurity

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