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 Innovative genetic tests for children with developmental disorders and epilepsy
11.07.2018 | Christian-Albrechts-Universität zu Kiel

nachricht Oxygen loss in the coastal Baltic Sea is “unprecedentedly severe”
05.07.2018 | European Geosciences Union

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: Future electronic components to be printed like newspapers

A new manufacturing technique uses a process similar to newspaper printing to form smoother and more flexible metals for making ultrafast electronic devices.

The low-cost process, developed by Purdue University researchers, combines tools already used in industry for manufacturing metals on a large scale, but uses...

Im Focus: First evidence on the source of extragalactic particles

For the first time ever, scientists have determined the cosmic origin of highest-energy neutrinos. A research group led by IceCube scientist Elisa Resconi, spokesperson of the Collaborative Research Center SFB1258 at the Technical University of Munich (TUM), provides an important piece of evidence that the particles detected by the IceCube neutrino telescope at the South Pole originate from a galaxy four billion light-years away from Earth.

To rule out other origins with certainty, the team led by neutrino physicist Elisa Resconi from the Technical University of Munich and multi-wavelength...

Im Focus: Magnetic vortices: Two independent magnetic skyrmion phases discovered in a single material

For the first time a team of researchers have discovered two different phases of magnetic skyrmions in a single material. Physicists of the Technical Universities of Munich and Dresden and the University of Cologne can now better study and understand the properties of these magnetic structures, which are important for both basic research and applications.

Whirlpools are an everyday experience in a bath tub: When the water is drained a circular vortex is formed. Typically, such whirls are rather stable. Similar...

Im Focus: Breaking the bond: To take part or not?

Physicists working with Roland Wester at the University of Innsbruck have investigated if and how chemical reactions can be influenced by targeted vibrational excitation of the reactants. They were able to demonstrate that excitation with a laser beam does not affect the efficiency of a chemical exchange reaction and that the excited molecular group acts only as a spectator in the reaction.

A frequently used reaction in organic chemistry is nucleophilic substitution. It plays, for example, an important role in in the synthesis of new chemical...

Im Focus: New 2D Spectroscopy Methods

Optical spectroscopy allows investigating the energy structure and dynamic properties of complex quantum systems. Researchers from the University of Würzburg present two new approaches of coherent two-dimensional spectroscopy.

"Put an excitation into the system and observe how it evolves." According to physicist Professor Tobias Brixner, this is the credo of optical spectroscopy....

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Leading experts in Diabetes, Metabolism and Biomedical Engineering discuss Precision Medicine

13.07.2018 | Event News

Conference on Laser Polishing – LaP: Fine Tuning for Surfaces

12.07.2018 | Event News

11th European Wood-based Panel Symposium 2018: Meeting point for the wood-based materials industry

03.07.2018 | Event News

 
Latest News

A smart safe rechargeable zinc ion battery based on sol-gel transition electrolytes

20.07.2018 | Power and Electrical Engineering

Reversing cause and effect is no trouble for quantum computers

20.07.2018 | Information Technology

Princeton-UPenn research team finds physics treasure hidden in a wallpaper pattern

20.07.2018 | Materials Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>