Marten J. Poley - Erasmus Universiteit Rotterdam

112Chapter 7Table 7.1 Economic Evaluations for Interventions in the Field of Neonatal Surgery (Published From 1999 Onwards)Studyno.Country oforigin Alternatives studiedTimehorizonPrimary analysis results, expressed as difference from thecomparatorIntervention Comparator Costs Effects Cost-effectiveness ratioRavitch's index diagnosesCongenitaldiaphragmatichernia88 Canada Inhaled nitric oxide Oxygen Untildischarge tohome ordeathIntestinal atresia –Esophageal atresia –and tracheoesophagealfistula25 Netherlands Neonatal surgery andsubsequent treatment89 * USA Inhaled nitric oxide Conventionalmanagement40 * UK ExtracorporealmembraneoxygenationImperforate anus 24 Netherlands Neonatal surgery andsubsequent treatmentHirschsprung'sdiseaseOmphalocele andgastroschisis90–USA One-stagelaparoscopic pullthroughNo treatment Basically lifetimeConventionalmanagementFirst year oflifeFirst 4 yearsof lifeNo treatment Basically lifetimeTwo-stage About 7 to 12Duhamel monthsprocedure+ CA$ 11,478 Higher mortality rate(50% v 40%)Needed not be calculated,because the intervention wasboth more costly and lesseffective+ € 42,658 + 17.5 QALY € 2,434 per QALY gained- US$ 1,880 +0.030 QALY Needed not be calculated,because the intervention wasboth less costly and moreeffective+ 17,367 Lower death orsevere disability rate(37% v 59%) 16,707 per life-year gained/ 24,775 per disability-freelife-year gained+ € 31,593 + 12.7 QALY € 2,482 per QALY gained- US$ 15,014 Fewer complications Needed not be calculated,because the intervention wasboth less costly and moreeffective