Strategies preventing late-onset infection (LOI) in preterm infants have a great potential to be cost-effective, even when minimally effective, according to the findings of a study published in Archives of Disease in Childhood.
The model-based cost-effective analysis used data from neonatal intensive care units across the UK for infants born ≤32 weeks gestational age, requiring a 1 French gauge peripherally inserted central catheters (PICCs). The model assumed that LOI increases the risk for neurodevelopmental impairment (NDI).
The analysis showed that severe NDI reduced life expectancy by 14.79 (95% CI, 4.43-26.68; undiscounted) years and 10.63 (95% CI, 7.74-14.02; discounted) quality-adjusted life years (QALYs), and it costs the NHS £19,057 (95% CI, £14,197-£24,697; discounted).
Assuming that LOI causes NDI, the maximum acquisition price of an intervention reducing LOI risk by 5 per cent was £120.
Anti-microbial impregnated PICCs (AM-PICCs) were associated with increased NDI costs (£54.85; 95% CI, £25.95-£89.12) but had negligible impact on health outcomes (QALYs, −0.01; 95% CI, −0.09 to 0.04), compared with standard PICCs.
The model quantifies health losses and additional health care costs caused by NDI and LOI during neonatal care. Given the findings, interventions preventing LOI, even by a small extent, can be cost-effective. AM-PICCs are less effective and more costly than standard PICC and are not likely to be cost-effective.