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 Real-time feedback helps save energy and water
08.02.2017 | Otto-Friedrich-Universität Bamberg

nachricht The Great Unknown: Risk-Taking Behavior in Adolescents
19.01.2017 | Max-Planck-Institut für Bildungsforschung

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: Breakthrough with a chain of gold atoms

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

Im Focus: DNA repair: a new letter in the cell alphabet

Results reveal how discoveries may be hidden in scientific “blind spots”

Cells need to repair damaged DNA in our genes to prevent the development of cancer and other diseases. Our cells therefore activate and send “repair-proteins”...

Im Focus: Dresdner scientists print tomorrow’s world

The Fraunhofer IWS Dresden and Technische Universität Dresden inaugurated their jointly operated Center for Additive Manufacturing Dresden (AMCD) with a festive ceremony on February 7, 2017. Scientists from various disciplines perform research on materials, additive manufacturing processes and innovative technologies, which build up components in a layer by layer process. This technology opens up new horizons for component design and combinations of functions. For example during fabrication, electrical conductors and sensors are already able to be additively manufactured into components. They provide information about stress conditions of a product during operation.

The 3D-printing technology, or additive manufacturing as it is often called, has long made the step out of scientific research laboratories into industrial...

Im Focus: Mimicking nature's cellular architectures via 3-D printing

Research offers new level of control over the structure of 3-D printed materials

Nature does amazing things with limited design materials. Grass, for example, can support its own weight, resist strong wind loads, and recover after being...

Im Focus: Three Magnetic States for Each Hole

Nanometer-scale magnetic perforated grids could create new possibilities for computing. Together with international colleagues, scientists from the Helmholtz Zentrum Dresden-Rossendorf (HZDR) have shown how a cobalt grid can be reliably programmed at room temperature. In addition they discovered that for every hole ("antidot") three magnetic states can be configured. The results have been published in the journal "Scientific Reports".

Physicist Dr. Rantej Bali from the HZDR, together with scientists from Singapore and Australia, designed a special grid structure in a thin layer of cobalt in...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Booth and panel discussion – The Lindau Nobel Laureate Meetings at the AAAS 2017 Annual Meeting

13.02.2017 | Event News

Complex Loading versus Hidden Reserves

10.02.2017 | Event News

International Conference on Crystal Growth in Freiburg

09.02.2017 | Event News

 
Latest News

Stingless bees have their nests protected by soldiers

24.02.2017 | Life Sciences

New risk factors for anxiety disorders

24.02.2017 | Life Sciences

MWC 2017: 5G Capital Berlin

24.02.2017 | Trade Fair News

VideoLinks
B2B-VideoLinks
More VideoLinks >>>