Journal de Pharmacie Clinique
MENUCost-benefit analysis of neonatal anemia prevention with recombinant human erythropoietin in premature infants Volume 25, issue 3, Juillet-Août-Septembre 2006
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- Key words: human recombinant erythropoietin, anemia, prematurity, blood transfusion, cost-benefit analysis
- Page(s) : 177-83
- Published in: 2006
Premature infants frequently develop anemia. This is the result from blood sampling and from a relatively poor erythropoietic response to anemia. As a result, these infants often receive multiple transfusions with the risk of viral disease transmission. Aim: to determine the efficacy and cost-effectiveness of recombinant human erythropoietin (r-HuEPO) in reducing erythrocyte transfusion needs in preterm infants. Methods: 79 premature infants of less than 34 weeks gestationnal age and/or with a birth weight of less than 1 500 g were admitted in our unit from March 1998 to June 1999. They received r-HuEPO 750 U/kg/week intravenously or subcutaneously from day 10. These infants were compared to a retrospective cohort of 79 premature infants born during 1997 before introduction of the protocol r-HuEPO and matched for gestationnal age and for weight at birth. Results: hemoglobin upon admission, phlebotomy losses, clinical parameters were similar in both groups. The median number of transfusions per infant was 0 compared with 1 transfusion per control infant (p < 0.0001). Median volume of erythrocytes transfused was 0 (0-23,8 mL/kg) in r-HuEPO-treated infants and 27.38 (0-62,5 mL/kg) in control infants (p < 0.0001). The number of infant without transfusion was significantly higher in the r-HuEPO-treated group (54.5 versus 26.6 %; p < 0.0001). The cost per patient was 189 euros for r-HuEPO recipient and 284 euros for control infant. The effect of R-HuEPO was not significant for infants with gestational age more than 32 weeks or BW more than 1 200 g. Conclusion: R-HuEPO is cost-effective in the prevention of anemia of prematurity for children born before 32 weeks or with a BW less than 1 200 g. This treatment does not exclude other procedures to prevent transfusion requirements.