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dc.contributor.authorChen, Ariel
Deshmukh, Ashish A.
Richards-Kortum, Rebecca
Molyneux, Elizabeth
Kawaza, Kondwani
Cantor, Scott B.
dc.date.accessioned 2014-12-01T17:26:01Z
dc.date.available 2014-12-01T17:26:01Z
dc.date.issued 2014
dc.identifier.citation Chen, Ariel, Deshmukh, Ashish A., Richards-Kortum, Rebecca, et al.. "Cost-effectiveness analysis of a low-cost bubble CPAP device in providing ventilatory support for neonates in Malawi - a preliminary report." BMC Pediatrics, 14, (2014) BioMed Central: 288. http://dx.doi.org/10.1186/s12887-014-0288-1.
dc.identifier.urihttps://hdl.handle.net/1911/78533
dc.description.abstract A low-cost bubble continuous positive airway pressure (bCPAP) device has been shown to be an excellent clinical alternative to nasal oxygen for the care of neonates with respiratory difficulty. However, the delivery of bCPAP requires more resources than the current routine care using nasal oxygen. We performed an economic evaluation to determine the cost-effectiveness of a low-cost bCPAP device in providing ventilatory support for neonates in Malawi. We used patient-level clinical data from a previously published non-randomized controlled study. Economic data were based on the purchase price of supplies and equipment, adjusted for shelf life, as well as hospital cost data from the World Health Organization. Costs and benefits were discounted at 3%. The outcomes were measured in terms of cost, discounted life expectancy, cost/life year gained and net benefits of using bCPAP or nasal oxygen. The incremental cost-effectiveness ratio and incremental net benefits determined the value of one intervention compared to the other. Subgroup analysis on several parameters (birth weight categories, diagnosis of respiratory distress syndrome, and comorbidity of sepsis) was conducted to evaluate the effect of these parameters on the cost-effectiveness. Nasal oxygen therapy was less costly (US$29.29) than the low-cost bCPAP device ($57.78). Incremental effectiveness associated with bCPAP was 6.78 life years (LYs). In the base case analysis, the incremental cost-effectiveness ratio for bCPAP relative to nasal oxygen therapy was determined to be $4.20 (95% confidence interval, US$2.29–US$16.67) per LY gained. The results were highly sensitive for all tested subgroups, particularly for neonates with birth weight 1– < 1.5 kg, respiratory distress syndrome, or comorbidity of sepsis; these subgroups had a higher probability that bCPAP would be cost effective. The bCPAP is a highly cost-effective strategy in providing ventilatory support for neonates in Malawi.
dc.language.iso eng
dc.publisher BioMed Central
dc.rightsThis article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.title Cost-effectiveness analysis of a low-cost bubble CPAP device in providing ventilatory support for neonates in Malawi - a preliminary report
dc.type Journal article
dc.contributor.funder Howard Hughes Medical Institute
dc.contributor.funder United States Agency for International Development
dc.contributor.funder Norway government
dc.contributor.funder Bill and Melinda Gates Foundation
dc.contributor.funder Grand Challenges Canada
dc.contributor.funder United Kingdom government
dc.citation.journalTitle BMC Pediatrics
dc.contributor.org Institute for Global Health Technologies
dc.subject.keywordcost-effectiveness analysis
neonate
Malawi
prematurity
respiratory distress syndrome
sepsis
ventilatory support
bubble continuous positive airway pressure
dc.citation.volumeNumber 14
dc.type.dcmi Text
dc.identifier.doihttp://dx.doi.org/10.1186/s12887-014-0288-1
dc.identifier.pmcid PMC4247223
dc.identifier.pmid 25421903
dc.identifier.grantID Precollege and Undergraduate Science Education Program (Howard Hughes Medical Institute)
dc.identifier.grantID Saving Lives at Birth Partners (United States Agency for International Development)
dc.type.publication publisher version
dc.citation.firstpage 288


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