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Caffeine Citrate Cost-Effective for Infant Apnea

Caffeine citrate results in less cost, better outcomes than placebo for apnea of prematurity

WEDNESDAY, Dec. 22 (HealthDay News) -- Use of caffeine citrate, at a cost of $0.21 (Canadian) per mg is both less expensive and more effective than placebo to treat apnea in premature infants, according to a study published online Dec. 20 in Pediatrics.

Dmitry Dukhovny, M.D., of Harvard Medical School in Boston, and colleagues evaluated cost per survivor without neurodevelopmental impairment in 1,869 infants from birth through 18 to 21 months' corrected age to determine the cost-effectiveness of caffeine treatment versus placebo for apnea in premature infants weighing less than 1250 g at birth. They used a price of $0.21 per mg of generic caffeine citrate for the base-case analysis. Costs were expressed in 2008 Canadian dollars and discounted at 3 percent.

The researchers determined that the mean cost for infants in the caffeine group was $124,466 (versus $133,505 in the placebo group) and that treatment with caffeine citrate was a "win-win" therapy. In more than 99 percent of 1,000 bootstrap replications of the analysis, infants treated with caffeine had better outcomes and lower costs than those treated with placebo. The results were robust to a 1,000 percent rise in individual resource items, including the cost of caffeine citrate.

"This retrospective economic evaluation supports a policy of caffeine use, relative to placebo, for apnea of prematurity in infants with a birth weight of less than 1250 g. The outcomes are economically appealing when measured at hospital discharge and up to 18 to 21 months' corrected age," the authors write.

Abstract
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