By | July 19, 2022

Bronchopulmonary Dysplasia

Bronchopulmonary Dysplasia and Pulmonary Hypertension (PHA)

For a study, researchers sought to compare the cost-utility of catheterization-required therapy in preterm babies with pulmonary hypertension to the empiric beginning of sildenafil based only on echocardiographic data.

A Markov state transition model was built to simulate the clinical scenario of a preterm infant with echocardiographic evidence of pulmonary hypertension associated with bronchopulmonary dysplasia (BPD) but no congenital heart disease who is considering starting pulmonary vasodilator therapy via one of two modeled treatment strategies–empiric or catheterization-obligate. The literature provided information on transitional probabilities, costs, utilities, and other relevant data. Predicted quality-adjusted live-years was the indicator of plan effectiveness. Each variable was tested for sensitivity. These findings were then tested for durability with a Monte Carlo microsimulation of 1,000 patients.

When compared to the empiric treatment technique, the catheterization-obligate strategy cost $10,778 more and resulted in 0.02 fewer quality-adjusted life-years. All scenarios analyzed using Monte Carlo microsimulation and one-way sensitivity analysis showed empiric treatment to be the most cost-effective (cost-effective for 98% of cases).

When compared to catheterization-obligate therapy, empiric sildenafil medication in babies with pulmonary hypertension associated with BPD is a superior method with lower costs and greater efficacy. Preterm children with pulmonary hypertension and BPD are able to skip catheterization.

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