[Comparison of the cost of treatment of premature labor with atosiban or beta-sympathomimetics from the perspective of the health care payer--a pharmacoeconomic model].
OBJECTIVE
To evaluate the cost of treating premature delivery with atosiban or beta-sympatomimetic drugs (fenoterol and hexoprenalin) from the perspective of health care payer--the medical insurance company.


METHODS
A pharmaco-economic model based on the results of randomized, controlled clinical study.


METHODS
Hospital Pharmacy at Vitkovice Hospital of Blessed Mary Antonia, Ostrava.


METHODS
The study is based on the application of clinical decision-making analysis, which includes results of a randomized controlled clinical study as well as data on the cost of clinical interventions and cost of drug therapy. The pharmaco-economic model was created from the perspective of the payer of health care--the insurance company. This model presumes the administration of atosiban or beta-sympatomimetic drugs (fenoterol and hexoprenalin) for the period of 18 and 48 h and the therapy of possible untoward effects for the next 72 h after the administration of the drugs. The analysis of sensitivity of pharmacokinetic model also employs so called low and high estimate of supplementary cost for the treatment of untoward effects.


RESULTS
After the administration of the drugs for the period of 18 h the total cost of the payer of medical care was in the range of 21,914.5-21,974.4 CKr in atosiban, 19,878.7-22,661.4 CKr in fenoterol and 19,942.9-21,974.4 CKr in hexoprenalin. In the administration of the drugs for 48 h, the overall cost of the payer of medical care was in the range of 43,082.5-43,142.4 CKr in atosiban, 19,960.3-23,150.7 CKr in fenoterol and 20,131.3-23,574.0 in hexoprenalin.


CONCLUSIONS
This study compared overall cost associated with hospitalization of a premature delivery from the perspective of the medical care payer, i.e. the health insurance company. The authors applied a pharmaco-economic model evaluating hospitalization for the period of 48 h and subsequent therapy of possible untoward effects for the period of up to 72 h. In case of a shorter administration of atosiban (up to 18 h) the overall cost of hospitalization for premature delivery for the period of 48 h from the point of view of medical insurance company is basically comparable with the administration of beta-sympatomimetic drugs. If atosiban is administered for more than 18 h, the overall cost of hospitalization is higher than with beta-sympatomimetic drugs, and the cost increases in relation to the duration of atosiban administration.
Hrubý
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Nemocnicní lékárna pri Vítkovické nemocnici Blahoslavené Marie Antoníny, Ostrava-Vítkovice.
D018153:Czech Republic; D016527:Drug Costs; D005260:Female; D005280:Fenoterol / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use; D017048:Health Care Costs; D006594:Hexoprenaline / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000191:economics*; D018803:Models, Economic; D007752:Obstetric Labor, Premature / Q000188:drug therapy* / Q000191:economics*; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic; D015149:Tocolytic Agents / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use; D014668:Vasotocin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000191:economics* / Q000627:therapeutic use
D015149:Tocolytic Agents; C047046:atosiban; D005280:Fenoterol; D006594:Hexoprenaline; D014668:Vasotocin