title: [Atosiban treatment for preterm labor--financial considerations and savings by implementing clinical guidelines].
abstract: BACKGROUND
  Preterm delivery is a significant cause of neonatal morbidity and mortality. Pregnant women, with symptoms and signs consistent with preterm labor, can be treated with various tocolytic drugs. Atosiban is one of many drugs indicated to arrest imminent preterm labor. Various studies show that the efficacy of atosiban is similar to other tocolytic drugs. The main advantage of atosiban is a relativeLy low incidence of adverse maternal reactions. Its considerable shortcoming is the financial cost, compared to other available drugs.
  
  
  OBJECTIVE
  In view of its cost, we have decided to implement a strict protocol to direct the use of atosiban, with the intent to reduce costs, without hampering quality of care.
  
  
  METHODS
  The protocol was implemented from July 2009, and it outlines the medical and procedural terms to use atosiban. We compared similar time periods before and after implementation of the protocol. The outcomes compared included: treatment success, rates of preterm deliveries and financial costs.
  
  
  RESULTS
  Within the timeframe that the protocol was implemented, we have been able to demonstrate a 40% reduction in atosiban related costs, compared to a parallel period, when the clinical guidelines were not implemented. This translates into savings of about NIS 40,000 (New Israeli Shekel) (approximately $10,000). This was achieved without an increase in the rate of preterm deliveries.
  
  
  CONCLUSIONS
  Implementing and enforcing a simple protocol of supervision on the use of atosiban enables a considerable reduction of financial costs related to atosiban, without hampering medical care.
authors.affiliation: Fetal Maternal Medicine Unit, Helen Schneider Hospital for Women, Rabin Medical Center. dolgaldor@hotmail.com
authors.forename: Eran
authors.initials: E
authors.lastname: Hadar
authors.forename: Nariman
authors.initials: N
authors.lastname: Mansur
authors.forename: Irit
authors.initials: I
authors.lastname: Ambar
authors.forename: Moshe
authors.initials: M
authors.lastname: Hod
mesh_terms: D017046:Cost Savings; D005260:Female; D006801:Humans; D007557:Israel; D007752:Obstetric Labor, Premature / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D047928:Premature Birth / Q000517:prevention & control; D011787:Quality of Health Care; D015149:Tocolytic Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D016896:Treatment Outcome; D014668:Vasotocin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use
chemical_list: D015149:Tocolytic Agents; C047046:atosiban; D014668:Vasotocin