Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

New study in pediatrics shows nitric oxide therapy for newborns effective and cost saving

08.12.2003


Breakthrough treatment benefits patients and is less expensive than standard therapy



An inhaled treatment for critically ill newborns is less invasive, more effective and costs less than the treatment that has traditionally been used to treat a potentially fatal condition called hypoxic respiratory failure (HRF), according to a study published today in the journal Pediatrics.

The study focuses on the positive effects of inhaled nitric oxide for the treatment of HRF and reveals a rarity in today’s world of rising medical costs: a breakthrough treatment that benefits patients and is less expensive than the standard treatment.


"It’s almost unprecedented to hear of an advanced medication that actually saves money compared with an older treatment," said Derek C. Angus, M.D., the study’s lead author and director of the Clinical Research, Investigation and Systems Modeling of Acute Illness (CRISMA) laboratory at the University of Pittsburgh. "When you are treating a critically ill baby, you want the best treatment available no matter what the cost. It’s heartening to learn that in the case of babies with hypoxic respiratory failure, we can offer state-of-the-art treatment that improves outcomes in comparison to traditional care and does so at potentially reduced costs overall."

HRF develops in newborns whose lungs cannot deliver enough oxygen to their bodies, causing them to appear bluish and endangering their lives. The condition often appears on the first day after birth, and affects about 30,000 full-term and near-term infants each year. There is no prenatal test or other way to predict which infants will develop HRF, so there is no known way to prevent the condition.

In the past, the only effective treatment for newborns with HRF who did not respond to standard care was an invasive surgical procedure known as extracorporeal membrane oxygenation (ECMO), which involves cutting a newborn’s jugular vein and putting the baby on a heart-lung machine to oxygenate the blood. Besides being invasive, the procedure has the potential to cause severe complications.

Nitric oxide, by contrast, is administered as an inhaled gas, and has few potential complications. But while hospital stays involving ECMO are reimbursed by private and government insurance plans, experts say that reimbursement for inhaled nitric oxide traditionally has been inadequate. This is based in large part on the fact that it is a newer treatment than ECMO, and thus reimbursement policies have not "caught up" to the fact that the therapy is now more widely used.

"Many therapies and life-saving equipment readily accepted by society are quite costly," said Maria Hardin, vice president of patient services for the National Organization for Rare Disorders (NORD). "Perhaps now that we have hard data on the cost savings this treatment provides, insurers will do a better job of covering it."

Key Study Findings

The new study shows that inhaled nitric oxide actually saves a significant amount of money when compared with the older and more invasive ECMO procedure:


For every 100 newborns with HRF, treatment with inhaled nitric oxide resulted in a cost savings of more than $440,000. This savings occurred among newborns who did not need to be transferred to another hospital for ECMO treatment.
Much of the cost savings stems from the avoidance of ECMO, a costly surgical procedure.
Treating newborns with inhaled nitric oxide at local hospitals (rather than higher-level hospitals that also provide ECMO) was most cost-effective, because when the treatment prevented the need for ECMO, it also prevented the cost of transferring the baby to the ECMO center.
Using the data from two randomized controlled trials and other real-life experiences with ECMO and inhaled nitric oxide, researchers at The University of Pittsburgh’s CRISMA laboratory developed a cost-effectiveness model that estimated treatment outcomes and costs associated with treatment and recovery. The researchers looked at two scenarios: a "base case" where babies were transferred to advanced-care hospitals where ECMO was available, and a "reference case," where nitric oxide therapy was administered at local hospitals. Both scenarios suggested that nitric oxide therapy was cheaper and more effective than ECMO. The base case study showed a savings of $1,880 per case, while the reference case showed an even higher savings – $4,400 per case.

"We now have strong evidence that I think will surprise many physicians and hospitals," Dr. Angus said. "Hopefully, this will encourage everyone to take a new look at just how important this therapy is."

In December 1999, the U.S. Food and Drug Administration (FDA) approved nitric oxide for inhalation (marketed under the trade name INOmax®) used in conjunction with ventilatory support and other appropriate agents, for the treatment of term and near-term (>34 weeks) neonates with HRF associated with clinical or echocardiographic evidence of pulmonary hypertension (high blood pressure in the lungs). The drug works by relaxing smooth-muscle cells in blood-vessel walls in the lungs, allowing the lungs to properly oxygenate the blood and provide it to the rest of the body. As with all pharmaceuticals, inhaled nitric oxide has side effects. The treating physician needs to assess the risk versus the benefit for the individual patient. This study was supported in part by a grant from INO Therapeutics, Inc., which manufactures INOmax®.

Todd Ringler | EurekAlert!
Further information:
http://www.edelman.com/

More articles from Studies and Analyses:

nachricht New study: How does Europe become a leading player for software and IT services?
03.04.2017 | Fraunhofer-Institut für System- und Innovationsforschung (ISI)

nachricht Reusable carbon nanotubes could be the water filter of the future, says RIT study
30.03.2017 | Rochester Institute of Technology

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Making lightweight construction suitable for series production

More and more automobile companies are focusing on body parts made of carbon fiber reinforced plastics (CFRP). However, manufacturing and repair costs must be further reduced in order to make CFRP more economical in use. Together with the Volkswagen AG and five other partners in the project HolQueSt 3D, the Laser Zentrum Hannover e.V. (LZH) has developed laser processes for the automatic trimming, drilling and repair of three-dimensional components.

Automated manufacturing processes are the basis for ultimately establishing the series production of CFRP components. In the project HolQueSt 3D, the LZH has...

Im Focus: Wonder material? Novel nanotube structure strengthens thin films for flexible electronics

Reflecting the structure of composites found in nature and the ancient world, researchers at the University of Illinois at Urbana-Champaign have synthesized thin carbon nanotube (CNT) textiles that exhibit both high electrical conductivity and a level of toughness that is about fifty times higher than copper films, currently used in electronics.

"The structural robustness of thin metal films has significant importance for the reliable operation of smart skin and flexible electronics including...

Im Focus: Deep inside Galaxy M87

The nearby, giant radio galaxy M87 hosts a supermassive black hole (BH) and is well-known for its bright jet dominating the spectrum over ten orders of magnitude in frequency. Due to its proximity, jet prominence, and the large black hole mass, M87 is the best laboratory for investigating the formation, acceleration, and collimation of relativistic jets. A research team led by Silke Britzen from the Max Planck Institute for Radio Astronomy in Bonn, Germany, has found strong indication for turbulent processes connecting the accretion disk and the jet of that galaxy providing insights into the longstanding problem of the origin of astrophysical jets.

Supermassive black holes form some of the most enigmatic phenomena in astrophysics. Their enormous energy output is supposed to be generated by the...

Im Focus: A Quantum Low Pass for Photons

Physicists in Garching observe novel quantum effect that limits the number of emitted photons.

The probability to find a certain number of photons inside a laser pulse usually corresponds to a classical distribution of independent events, the so-called...

Im Focus: Microprocessors based on a layer of just three atoms

Microprocessors based on atomically thin materials hold the promise of the evolution of traditional processors as well as new applications in the field of flexible electronics. Now, a TU Wien research team led by Thomas Müller has made a breakthrough in this field as part of an ongoing research project.

Two-dimensional materials, or 2D materials for short, are extremely versatile, although – or often more precisely because – they are made up of just one or a...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Expert meeting “Health Business Connect” will connect international medical technology companies

20.04.2017 | Event News

Wenn der Computer das Gehirn austrickst

18.04.2017 | Event News

7th International Conference on Crystalline Silicon Photovoltaics in Freiburg on April 3-5, 2017

03.04.2017 | Event News

 
Latest News

DGIST develops 20 times faster biosensor

24.04.2017 | Physics and Astronomy

Nanoimprinted hyperlens array: Paving the way for practical super-resolution imaging

24.04.2017 | Materials Sciences

Atomic-level motion may drive bacteria's ability to evade immune system defenses

24.04.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>