Pharmaceutical Expenditure Is Unchanged with Ultrasound-Guided Surfactant Administration

Abstract

Objective Semiquantitative lung ultrasound improves the timeliness of surfactant replacement, but its financial consequences are unknown. We aim to investigate if the ultrasound-guided surfactant administration influences the general costs of surfactant therapy for preterm neonates affected by respiratory distress syndrome.

Study Design This is a pharmacoeconomic, retrospective, and before-and-after study investigating the impact of ultrasound-guided surfactant replacement (echography-guided Surfactant THERapy [ESTHER]) on pharmaceutical expenditure within the ESTHER initiative. Data extracted from the institutional official database hosted by the hospital administration for financial management were used for the analysis. We analyzed the number of surfactant administrations in neonates of gestational age ≤32^6/7 weeks, and the number of surfactant vials used from January 1_, 2014 to June 30, 2014 (i.e., during the period of standard surfactant administration policy) and from July 1, 2016 to December 31, 2018 (that is during ESTHER policy).

Results ESTHER did not modify surfactant use, as proportion of treated neonates with RDS receiving at least one surfactant dose (Standard: 21.3% vs. ESTHER: 20.9%; p = 0.876) or as proportion of used vials over the total number of vials opened for neonates of any gestational age (Standard: 37% vs. ESTHER: 35%; p = 0.509).

Conclusion Ultrasound-guided surfactant replacement using a semiquantitative lung ultrasound score in preterm infants with RDS does not change the global use of surfactant and the related expenditure.

Key Points

• ESTHER is able to increase the timeliness of surfactant replacement.

• The ultrasound-guided surfactant administration does not increase the cost of surfactant therapy.

• The ultrasound-guided surfactant administration does not change the global surfactant utilization.

Keywords

lung ultrasound - surfactant - preterm neonate - respiratory distress syndrome

Note

The results of this study were never presented in any meeting abstract.

Authors' Contributions

Both authors are guarantors and take responsibility for the manuscript content. D.D.L. and N.Y. equally contributed to study conception and design. They drafted the article and revised it for important intellectual content. D.D.L. performed the data analysis and supervised the whole project. Both authors approved the final version to be published.

Publikationsverlauf

Eingereicht: 21. Mai 2020

Angenommen: 20. Juli 2020

Artikel online veröffentlicht:
20. August 2020

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