Prospective economic evaluation alongside the non-invasive ventilation trial.
To determine the cost-effectiveness of nasal continuous positive pressure (nCPAP) compared with nasal intermittent positive pressure ventilation (NIPPV) in the context of the reported randomized clinical trial.



Using patient-level data from the clinical trial, we undertook a prospectively planned economic evaluation. We measured costs, from a third-party payer perspective in all patients, and from a societal perspective in a subgroup with a time horizon through the earlier of discharge, death or 44 weeks post-menstrual age.



From the third-party payer perspective, the mean cost of hospitalization per infant was statistically similar, $143 745 in the NIPPV group compared to $140 403 in the nCPAP group. Cost-effectiveness evaluation revealed a 61% probability that NIPPV is more expensive and less effective than nCPAP. Similar results were found in subgroup analysis from a societal perspective.



In addition to being clinically equivalent, economic evaluation confirms that NIPPV, as employed in this trial, is also not economically favorable.
Department of Pediatrics, Division of Neonatology, University of Florida, Gainesville, FL, USA.
M E
ME
Mowitz
Department of Pediatrics, Harvard Medical School, Boston, MA, USA.|Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA, USA.|Boston Children's Hospital, Boston, MA, USA.
J A F
JA
Zupancic
Royal Maternity Hospital, Belfast, UK.
D
D
Millar
The Children's Hospital of Philadelphia, Philadelphia, PA, USA.|McMaster University, Hamilton, ON, Canada.
H
H
Kirpalani
Boston Children's Hospital, Boston, MA, USA.
J S
JS
Gaulton
The Children's Hospital of Philadelphia, Philadelphia, PA, USA.|McMaster University, Hamilton, ON, Canada.
R S
RS
Roberts
Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
W
W
Mao
Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA, USA.|Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA.
D
D
Dukhovny
D045422:Continuous Positive Airway Pressure / Q000191:economics* / Q000379:methods; D003362:Cost-Benefit Analysis / Q000706:statistics & numerical data*; D005260:Female; D005865:Gestational Age; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal / Q000191:economics; D007385:Intermittent Positive-Pressure Ventilation / Q000191:economics* / Q000379:methods; D008297:Male; D063087:Noninvasive Ventilation / Q000379:methods; D011446:Prospective Studies; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy; D012680:Sensitivity and Specificity
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