A Cost-Effectiveness Analysis of Rooming-in and Breastfeeding in Neonatal Opioid Withdrawal
Our cost-effectiveness analysis investigated rooming-in versus not rooming-in to determine optimal management of neonates with neonatal opioid withdrawal (NOW). A decision-analytic model was constructed using TreeAge to compare rooming-in versus not rooming-in in a theoretical cohort of 23,200 newbo...
Saved in:
Published in | American journal of perinatology Vol. 37; no. 1; p. 1 |
---|---|
Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
United States
01.01.2020
|
Online Access | Get more information |
Cover
Loading…
Abstract | Our cost-effectiveness analysis investigated rooming-in versus not rooming-in to determine optimal management of neonates with neonatal opioid withdrawal (NOW).
A decision-analytic model was constructed using TreeAge to compare rooming-in versus not rooming-in in a theoretical cohort of 23,200 newborns, the estimated annual number affected by NOW in the United States. Additional considerations included the effect of breast milk versus formula milk in evaluating the need for pharmacotherapy. Primary outcomes were needed for pharmacotherapy and neurodevelopment. We assumed a societal perspective in evaluating costs and maternal-neonatal quality-adjusted life years (QALYs) using a willingness-to-pay threshold of $100,000/QALY. Model inputs were derived from literature and varied in sensitivity analyses.
Rooming-in resulted in fewer neonates requiring pharmacotherapy when compared with not rooming-in. The rooming-in group had more neonates with intact/mild neurodevelopmental impairment and fewer cases of moderate to severe impairment. Rooming-in resulted in cost savings of $509,652,728 and 12,333 additional QALYs per annual cohort. When the risk ratio of need for pharmacotherapy in rooming-in was varied across a clinically plausible range, rooming-in remained the cost-effective strategy.
Maternal rooming-in with newborns affected by NOW leads to reduced costs and increased effectiveness. Management strategies should optimize nonpharmacological interventions as first-line treatment. |
---|---|
AbstractList | Our cost-effectiveness analysis investigated rooming-in versus not rooming-in to determine optimal management of neonates with neonatal opioid withdrawal (NOW).
A decision-analytic model was constructed using TreeAge to compare rooming-in versus not rooming-in in a theoretical cohort of 23,200 newborns, the estimated annual number affected by NOW in the United States. Additional considerations included the effect of breast milk versus formula milk in evaluating the need for pharmacotherapy. Primary outcomes were needed for pharmacotherapy and neurodevelopment. We assumed a societal perspective in evaluating costs and maternal-neonatal quality-adjusted life years (QALYs) using a willingness-to-pay threshold of $100,000/QALY. Model inputs were derived from literature and varied in sensitivity analyses.
Rooming-in resulted in fewer neonates requiring pharmacotherapy when compared with not rooming-in. The rooming-in group had more neonates with intact/mild neurodevelopmental impairment and fewer cases of moderate to severe impairment. Rooming-in resulted in cost savings of $509,652,728 and 12,333 additional QALYs per annual cohort. When the risk ratio of need for pharmacotherapy in rooming-in was varied across a clinically plausible range, rooming-in remained the cost-effective strategy.
Maternal rooming-in with newborns affected by NOW leads to reduced costs and increased effectiveness. Management strategies should optimize nonpharmacological interventions as first-line treatment. |
Author | Yieh, Leah Caughey, Aaron B Dukhovny, Dmitry Avram, Carmen M |
Author_xml | – sequence: 1 givenname: Carmen M surname: Avram fullname: Avram, Carmen M organization: Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon – sequence: 2 givenname: Leah surname: Yieh fullname: Yieh, Leah organization: Fetal and Neonatal Institute, Children's Hospital of Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California – sequence: 3 givenname: Dmitry surname: Dukhovny fullname: Dukhovny, Dmitry organization: Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon – sequence: 4 givenname: Aaron B surname: Caughey fullname: Caughey, Aaron B organization: Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31370065$$D View this record in MEDLINE/PubMed |
BookMark | eNo1j8tKAzEUQIMo9qFbl5IfiOYxmWSWtbQqFAuiuHBRbiY3GpkmZTIq_XsL6urAWRw4E3KcckJCLgS_Elzr68I4Vw0TdaOMqI_IWPDGMmusHpFJKR-cC2m5PSUjJZThvNZj8jqj81wGtggB2yF-YcJS6CxBty-x0BzoY87bmN5YTBSSpzc9QhkCoj9IepAPmBMM0NH1Lubo6Usc3n0P39CdkZMAXcHzP07J83LxNL9jq_Xt_Xy2Yq1SamDO2QBYNSC9U20trfYGeGjBGHRV47mX2rhKQWPr1lqJ6FAHLeFwV3kt5JRc_nZ3n26LfrPr4xb6_eb_Uv4AfDRU0w |
CitedBy_id | crossref_primary_10_1542_peds_2023_063635 crossref_primary_10_4037_ajcc2023790 crossref_primary_10_1016_j_cnc_2023_11_005 crossref_primary_10_1007_s10995_022_03497_0 crossref_primary_10_1016_j_pedn_2020_08_008 crossref_primary_10_3390_children8070534 crossref_primary_10_1097_AOG_0000000000004786 crossref_primary_10_1016_j_jpeds_2022_02_001 |
ContentType | Journal Article |
Copyright | Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA. |
Copyright_xml | – notice: Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA. |
DBID | NPM |
DOI | 10.1055/s-0039-1693716 |
DatabaseName | PubMed |
DatabaseTitle | PubMed |
DatabaseTitleList | PubMed |
Database_xml | – sequence: 1 dbid: NPM name: PubMed url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database |
DeliveryMethod | no_fulltext_linktorsrc |
Discipline | Medicine |
EISSN | 1098-8785 |
ExternalDocumentID | 31370065 |
Genre | Journal Article |
GroupedDBID | --- .GJ 0R~ 1UC 23M 34G 39C 4.4 53G 5GY 5RE 5~~ 6J9 AAKAS AAQOH AAWTL ABJNI ABPPZ ACGFS ADZCM AENEX AFFNX AHRAW AHRSK AIVKU AJGCD ALMA_UNASSIGNED_HOLDINGS BPGNG C45 CAG COF CS3 EBS EJD EXEOM F5P H13 IY8 L7B N9A NPM O9- OVD Q3R QTC RIG ROL RTC TEORI YFH ZB8 ZGI ZXP |
ID | FETCH-LOGICAL-c333t-bb8fae49a2db3c6285d7a0fca77eb49d0d257b43a986c882eebe5f52a0984d512 |
IngestDate | Sat Sep 28 08:29:52 EDT 2024 |
IsPeerReviewed | true |
IsScholarly | true |
Issue | 1 |
Language | English |
License | Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA. |
LinkModel | OpenURL |
MergedId | FETCHMERGED-LOGICAL-c333t-bb8fae49a2db3c6285d7a0fca77eb49d0d257b43a986c882eebe5f52a0984d512 |
PMID | 31370065 |
ParticipantIDs | pubmed_primary_31370065 |
PublicationCentury | 2000 |
PublicationDate | 2020-01-01 |
PublicationDateYYYYMMDD | 2020-01-01 |
PublicationDate_xml | – month: 01 year: 2020 text: 2020-01-01 day: 01 |
PublicationDecade | 2020 |
PublicationPlace | United States |
PublicationPlace_xml | – name: United States |
PublicationTitle | American journal of perinatology |
PublicationTitleAlternate | Am J Perinatol |
PublicationYear | 2020 |
SSID | ssj0012808 |
Score | 2.3241758 |
Snippet | Our cost-effectiveness analysis investigated rooming-in versus not rooming-in to determine optimal management of neonates with neonatal opioid withdrawal... |
SourceID | pubmed |
SourceType | Index Database |
StartPage | 1 |
Title | A Cost-Effectiveness Analysis of Rooming-in and Breastfeeding in Neonatal Opioid Withdrawal |
URI | https://www.ncbi.nlm.nih.gov/pubmed/31370065 |
Volume | 37 |
hasFullText | |
inHoldings | 1 |
isFullTextHit | |
isPrint | |
link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV3Pb9MwFLa6IU27oDF-bAyQD1wNXhzHzrHrQBNi5bJJQxwmO7ZpNDWtunRI3Pm_eY5jkowhGJeospW2yvf55b3n9z4j9FqoLIfAoSA0cYz447VJzoUikjlJuTRGN4Hi6TQ7OU8_XPCL0ehHr2ppXes3xfc7-0r-B1UYA1x9l-w9kP31pTAAnwFfuALCcP0njH1L-XVNggJxNFsDmRFwi-HdRMpQcnzkK9BrF15YPtMxtT55Dih9WpaL0oCNqGdmpb61PxzVaeOuTk9mwgskw62DpPz4ZhXoNVGrua26ROvn0jbZm4-2yz4fr69mi5sqbOLPy7orR56o9ddZyKSP1QrYedRPTSS0l5qwwZx6tVIpwqE80d4GkZcBr4LxPLzTpFPu1S-uie8iJl46RoTmzB6-y3kDMDtkwrtUf5-9JbEdpzbQhpD-_I-pT_m0W1GJpDKqfXL-dvhHttFWvPlWXNL4J2c76GEbWOBxYMkjNLLVLto6bUsnHqMvY_w7WXAkC1443JEFA1nwgCwYBiNZcCAL7sjyBJ2_f3c2OSHtyRqkYIzVRGvplE1zlcBaLHwXrRGKukIJYXWaG2rAkuuUqVxmBcRgFpY6dzxRgGdqwEd8ijarRWX3EOYJtTLLqMkdT522uaAytYblGiJtnah99Cw8lstlkE-5jA_s-R9nDtB2R6cX6IGD9WpfgvNX61cNOD8BdThaDQ |
link.rule.ids | 780 |
linkProvider | National Library of Medicine |
openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=A+Cost-Effectiveness+Analysis+of+Rooming-in+and+Breastfeeding+in+Neonatal+Opioid+Withdrawal&rft.jtitle=American+journal+of+perinatology&rft.au=Avram%2C+Carmen+M&rft.au=Yieh%2C+Leah&rft.au=Dukhovny%2C+Dmitry&rft.au=Caughey%2C+Aaron+B&rft.date=2020-01-01&rft.eissn=1098-8785&rft.volume=37&rft.issue=1&rft.spage=1&rft_id=info:doi/10.1055%2Fs-0039-1693716&rft_id=info%3Apmid%2F31370065&rft_id=info%3Apmid%2F31370065&rft.externalDocID=31370065 |