Drug therapy can reduce preterm births and decrease lifetime medical costs

Researchers from MetroHealth Medical Center and Case Western Reserve University in Cleveland, OH found that treating expectant mothers who have had previous spontaneous preterm births with 17 Alpha Hydroxyprogesterone caproate (17P) and reducing the incidence of another preterm birth would consequently reduce both short-term and lifetime medical costs in offspring by $2 billion per year.

The results of their study are reported in the March issue of the American Journal of Obstetrics & Gynecology.

"In the United States, preterm birth is the leading cause of neonatal deaths and the leading cause of pediatric neuro-developmental disability, including cerebral palsy and mental retardation. It is also an important cause of chronic lung disease, visual impairment, and other chronic illness in children." That statement, from an editorial authored by Joanne Armstrong, MD, MPH, of Baylor College of Medicine in Houston, TX, and Senior Medical Director, Women's Health for Aetna, also appears in the March issue of the American Journal of Obstetrics & Gynecology. It reinforces why the results of the study are particularly significant.

Combining data from six studies of the costs of preterm births with estimates of the effectiveness of 17P in seven other studies, the investigators determined that initial neonatal hospital costs could be reduced by $3800 per woman treated and could lead to a reduction in lifetime medical costs of $15,900 per child. Senior investigator Jennifer Bailit MD, MPH, of the MetroHealth Medical Center states, "If the eligible population was universally treated with 17P, discounted lifetime medical costs of their offspring could be reduced by more than $2 billion annually. The potential societal savings from Medicaid coverage of 17P are substantial."

Dr. Armstrong continues in the editorial, "As more evidence accumulates about the effectiveness of 17P to prevent preterm birth, the current work of Bailit and colleagues provides valuable information about the magnitude of the cost benefit of 17P that can help inform health policy decisions and guide resource investments in the prevention of preterm birth." At the present time 17P is not yet FDA approved for this indication.

The Journal editors add, "We urge readers to share both Dr. Bailit's analysis and Dr. Armstrong's commentary with colleagues and third-party payers."