Atosiban versus betamimetics in the treatment of preterm labour in Italy: clinical and economic importance of side-effects.

摘要

The aim of this study was to determine the cost effectiveness of atosiban compared to betamimetics in the treatment of preterm labour within the Italian setting. A systematic literature review identified randomised controlled trials (RCTs) comparing atosiban with betamimetics. Meta-analysis of nine RCTs determined that atosiban and betamimetics had similar efficacy in delaying preterm birth by at least 48 h (p=0.910). Use of atosiban was associated with significantly fewer adverse events (p<0.008). Results demonstrate that atosiban is cost-saving versus ritodrine or isoxuprine. Atosiban cost savings are euro657 per patient from the National Health Service payer's perspective; euro299 at 18 h of tocolysis to euro189 at 48 h from the hospital's perspective. The respective values versus isoxuprine were euro303 and euro199. From the combined perspective, using atosiban versus ritodrine saved from euro425 to euro316; and versus isoxuprine from euro429 to euro326. Owing to its superior safety profile, atosiban is cost-saving versus betamimetics in the treatment of preterm labour in Italy from the payer's, hospital's and combined perspectives. With the approximate 40,000 annual preterm births in Italy the annual savings could be in excess of euro13 million for the payer or euro3.8-6.2 million for the hospitals.