title: Atosiban versus betamimetics in the treatment of preterm labour in Italy: clinical and economic importance of side-effects.
abstract: The aim of this study was to determine the cost effectiveness of atosiban compared to betamimetics in the treatment of preterm labour within the Italian setting. A systematic literature review identified randomised controlled trials (RCTs) comparing atosiban with betamimetics. Meta-analysis of nine RCTs determined that atosiban and betamimetics had similar efficacy in delaying preterm birth by at least 48 h (p=0.910). Use of atosiban was associated with significantly fewer adverse events (p<0.008). Results demonstrate that atosiban is cost-saving versus ritodrine or isoxuprine. Atosiban cost savings are €657 per patient from the National Health Service payer's perspective; €299 at 18 h of tocolysis to €189 at 48 h from the hospital's perspective. The respective values versus isoxuprine were €303 and €199. From the combined perspective, using atosiban versus ritodrine saved from €425 to €316; and versus isoxuprine from €429 to €326. Owing to its superior safety profile, atosiban is cost-saving versus betamimetics in the treatment of preterm labour in Italy from the payer's, hospital's and combined perspectives. With the approximate 40,000 annual preterm births in Italy the annual savings could be in excess of €13 million for the payer or €3.8-6.2 million for the hospitals.
authors.affiliation: PharmArchitecture Limited, 145-157 St. John Street, London, EC1V 4PY, United Kingdom. jaro.wex@pharmarchitecture.com
authors.forename: Jaro
authors.initials: J
authors.lastname: Wex
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Abou-Setta
authors.forename: Graziano
authors.initials: G
authors.lastname: Clerici
authors.forename: Gian Carlo
authors.initials: GC
authors.lastname: Di Renzo
mesh_terms: D000318:Adrenergic beta-Agonists / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007556:Isoxsuprine / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D007558:Italy; D007752:Obstetric Labor, Premature / Q000191:economics / Q000517:prevention & control*; D011247:Pregnancy; D012312:Ritodrine / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D015149:Tocolytic Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D014668:Vasotocin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use
chemical_list: D000318:Adrenergic beta-Agonists; D015149:Tocolytic Agents; C047046:atosiban; D012312:Ritodrine; D007556:Isoxsuprine; D014668:Vasotocin