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 Win-win strategies for climate and food security
02.10.2017 | International Institute for Applied Systems Analysis (IIASA)

nachricht The personality factor: How to foster the sharing of research data
06.09.2017 | ZBW – Leibniz-Informationszentrum Wirtschaft

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: Neutron star merger directly observed for the first time

University of Maryland researchers contribute to historic detection of gravitational waves and light created by event

On August 17, 2017, at 12:41:04 UTC, scientists made the first direct observation of a merger between two neutron stars--the dense, collapsed cores that remain...

Im Focus: Breaking: the first light from two neutron stars merging

Seven new papers describe the first-ever detection of light from a gravitational wave source. The event, caused by two neutron stars colliding and merging together, was dubbed GW170817 because it sent ripples through space-time that reached Earth on 2017 August 17. Around the world, hundreds of excited astronomers mobilized quickly and were able to observe the event using numerous telescopes, providing a wealth of new data.

Previous detections of gravitational waves have all involved the merger of two black holes, a feat that won the 2017 Nobel Prize in Physics earlier this month....

Im Focus: Smart sensors for efficient processes

Material defects in end products can quickly result in failures in many areas of industry, and have a massive impact on the safe use of their products. This is why, in the field of quality assurance, intelligent, nondestructive sensor systems play a key role. They allow testing components and parts in a rapid and cost-efficient manner without destroying the actual product or changing its surface. Experts from the Fraunhofer IZFP in Saarbrücken will be presenting two exhibits at the Blechexpo in Stuttgart from 7–10 November 2017 that allow fast, reliable, and automated characterization of materials and detection of defects (Hall 5, Booth 5306).

When quality testing uses time-consuming destructive test methods, it can result in enormous costs due to damaging or destroying the products. And given that...

Im Focus: Cold molecules on collision course

Using a new cooling technique MPQ scientists succeed at observing collisions in a dense beam of cold and slow dipolar molecules.

How do chemical reactions proceed at extremely low temperatures? The answer requires the investigation of molecular samples that are cold, dense, and slow at...

Im Focus: Shrinking the proton again!

Scientists from the Max Planck Institute of Quantum Optics, using high precision laser spectroscopy of atomic hydrogen, confirm the surprisingly small value of the proton radius determined from muonic hydrogen.

It was one of the breakthroughs of the year 2010: Laser spectroscopy of muonic hydrogen resulted in a value for the proton charge radius that was significantly...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

ASEAN Member States discuss the future role of renewable energy

17.10.2017 | Event News

World Health Summit 2017: International experts set the course for the future of Global Health

10.10.2017 | Event News

Climate Engineering Conference 2017 Opens in Berlin

10.10.2017 | Event News

 
Latest News

Electrode materials from the microwave oven

19.10.2017 | Materials Sciences

New material for digital memories of the future

19.10.2017 | Materials Sciences

Physics boosts artificial intelligence methods

19.10.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>