María Álvarez-Fuente1, Luis Arruza2, Marta Muro3, Carlos Zozaya4, Alejandro Avila5, Paloma López-Ortego4, Carmen González-Armengod3, Alba Torrent6, Jose Luis Gavilán7, María Jesús Del Cerro8. 1. Hospital Ramón y Cajal, Carrtera de Colmenar Viejo Km 9.1, 28034, Madrid, Spain. m.alvarez.fuente@salud.madrid.org. 2. Hospital Clinico San Carlos, Madrid, Spain. 3. Hospital Puerta de Hierro, Madrid, Spain. 4. Hospital La Paz, Madrid, Spain. 5. Complejo Hospitalario de A Coruña, A Coruña, Spain. 6. Hospital Vall D'Hebron, Barcelona, Spain. 7. Hospital Virgen del Rocio, Seville, Spain. 8. Hospital Ramón y Cajal, Carrtera de Colmenar Viejo Km 9.1, 28034, Madrid, Spain.
Abstract
Bronchopulmonary dysplasia (BPD) is one of the most serious chronic lung diseases in infancy and one of the most important sequels of premature birth (prevalence of 15-50%). Our objective was to estimate the cost of BPD of one preterm baby, with no other major prematurity-related complications, during the first 2 years of life in Spain. Data from the Spanish Ministry of Health regarding costs of diagnosis-related group of preterm birth, hospital admissions and visits, palivizumab administration, and oxygen therapy in the year 2013 were analyzed. In 2013, 2628 preterm babies were born with a weight under 1500 g; 50.9% were males. The need for respiratory support was 2.5% needed only oxygen therapy, 39.5% required conventional mechanical ventilation, and 14.9% required high-frequency ventilation. The incidence of BPD was of 34.9%. The cost of the first 2 years of life of a preterm baby with BPD and no other major prematurity-related complications ranged between 45,049.81 € and 118,760.43 €, in Spain, depending on birth weight and gestational age. If the baby required home oxygen therapy or developed pulmonary hypertension, this cost could add up to 181,742.43 €. CONCLUSION: Prematurity and BPD have an elevated cost, even for public health care systems. This cost will probably increase in the coming years if the incidence and survival of preterm babies keeps rising. The development of new therapies and preventive strategies to decrease the incidence of BPD and other morbidities associated with prematurity should be a priority. What is known: • Bronchopulmonary dysplasia (BPD) is a serious chronic lung disease related with premature birth. • BPD is an increasing disease due to the up-rise in the number of premature births. What is new: • The economic cost of preterm birth and BPD has never before been estimated in Spain nor published with European data. • Preterm babies with BPD and a good clinical outcome carry also an important economic and social burden.
Bronchopulmonary dysplasia (BPD) is one of the most serious chronic lung diseases in infancy and one of the most important sequels of premature birth (prevalence of 15-50%). Our objective was to estimate the cost of BPD of one preterm baby, with no other major prematurity-related complications, during the first 2 years of life in Spain. Data from the Spanish Ministry of Health regarding costs of diagnosis-related group of preterm birth, hospital admissions and visits, palivizumab administration, and oxygen therapy in the year 2013 were analyzed. In 2013, 2628 preterm babies were born with a weight under 1500 g; 50.9% were males. The need for respiratory support was 2.5% needed only oxygen therapy, 39.5% required conventional mechanical ventilation, and 14.9% required high-frequency ventilation. The incidence of BPD was of 34.9%. The cost of the first 2 years of life of a preterm baby with BPD and no other major prematurity-related complications ranged between 45,049.81 € and 118,760.43 €, in Spain, depending on birth weight and gestational age. If the baby required home oxygen therapy or developed pulmonary hypertension, this cost could add up to 181,742.43 €. CONCLUSION: Prematurity and BPD have an elevated cost, even for public health care systems. This cost will probably increase in the coming years if the incidence and survival of preterm babies keeps rising. The development of new therapies and preventive strategies to decrease the incidence of BPD and other morbidities associated with prematurity should be a priority. What is known: • Bronchopulmonary dysplasia (BPD) is a serious chronic lung disease related with premature birth. • BPD is an increasing disease due to the up-rise in the number of premature births. What is new: • The economic cost of preterm birth and BPD has never before been estimated in Spain nor published with European data. • Preterm babies with BPD and a good clinical outcome carry also an important economic and social burden.
Authors: Ludwig Gortner; Björn Misselwitz; David Milligan; Jennifer Zeitlin; Louis Kollée; Klaus Boerch; Rocco Agostino; Patrick Van Reempts; Jean-Louis Chabernaud; Gérard Bréart; Emile Papiernik; Pierre-Henri Jarreau; Manuel Carrapato; Janusz Gadzinowski; Elizabeth Draper Journal: Neonatology Date: 2010-08-23 Impact factor: 4.035
Authors: Stacy Beck; Daniel Wojdyla; Lale Say; Ana Pilar Betran; Mario Merialdi; Jennifer Harris Requejo; Craig Rubens; Ramkumar Menon; Paul F A Van Look Journal: Bull World Health Organ Date: 2009-09-25 Impact factor: 9.408
Authors: Cameron F Gunville; Marci K Sontag; Kristin A Stratton; Daksha J Ranade; Steven H Abman; Peter M Mourani Journal: J Pediatr Date: 2010-03-24 Impact factor: 4.406
Authors: Adam J Lewandowski; William M Bradlow; Daniel Augustine; Esther F Davis; Jane Francis; Atul Singhal; Alan Lucas; Stefan Neubauer; Kenny McCormick; Paul Leeson Journal: Circulation Date: 2013-08-13 Impact factor: 29.690
Authors: L B DeVries; R J Heyne; C Ramaciotti; L S Brown; M A Jaleel; V S Kapadia; P J Burchfield; L P Brion Journal: J Perinatol Date: 2017-06-15 Impact factor: 2.521
Authors: Ekta Khemani; Doff B McElhinney; Lawrence Rhein; Olyn Andrade; Ronald V Lacro; Kristin C Thomas; Mary P Mullen Journal: Pediatrics Date: 2007-12 Impact factor: 7.124
Authors: Katherine Y Wu; Erik A Jensen; Ammie M White; Yan Wang; David M Biko; Kathleen Nilan; María V Fraga; Laura Mercer-Rosa; Huayan Zhang; Haresh Kirpalani Journal: Am J Respir Crit Care Med Date: 2020-06-01 Impact factor: 21.405
Authors: Cristina Ramos-Navarro; Elena Maderuelo-Rodríguez; Ana Concheiro-Guisán; Santiago Pérez-Tarazona; Santiago Rueda-Esteban; Ana Sánchez-Torres; Manuel Sánchez-Solís; Ester Sanz-López; Manuel Sánchez-Luna Journal: Eur J Pediatr Date: 2021-10-01 Impact factor: 3.183
Authors: Amrit Kumar Shrestha; Matthew L Bettini; Renuka T Menon; Vashisht Y N Gopal; Shixia Huang; Dean P Edwards; Mohan Pammi; Roberto Barrios; Binoy Shivanna Journal: Am J Physiol Lung Cell Mol Physiol Date: 2018-10-11 Impact factor: 5.464
Authors: Michal A Elovitz; Pawel Gajer; Valerie Riis; Amy G Brown; Michael S Humphrys; Johanna B Holm; Jacques Ravel Journal: Nat Commun Date: 2019-03-21 Impact factor: 14.919
Authors: Erik A Jensen; Kevin Dysart; Marie G Gantz; Scott McDonald; Nicolas A Bamat; Martin Keszler; Haresh Kirpalani; Matthew M Laughon; Brenda B Poindexter; Andrea F Duncan; Bradley A Yoder; Eric C Eichenwald; Sara B DeMauro Journal: Am J Respir Crit Care Med Date: 2019-09-15 Impact factor: 21.405