A Cost Minimization Comparison of Two Surfactants-Beractant and Poractant alfa-Based Upon Prospectively Designed, Comparative Clinical Trial Data

Objectives: To compare the pharmacoeconomic profiles of beractant (Survanta(®), Ross Laboratories, Columbus, Ohio) and poractant alfa (Curosurf(®), DEY LP, Napa, CA) via a cost-minimization analysis.

Methods: This analysis was based upon clinical data from two previously published studies (Speer C, et al. Arch Dis Child 1995;72: F8-13; and Ramanathan R, et al. Am J Perinatol 2004; 21:109-19) where investigators found significant differences in the number of doses required to achieve a similar clinical response. Our analyses employed several models based upon single-use or multiple-use of single-use vial scenarios, average wholesale pricing, and costs computed on a per-patient basis. Model 1 involved single-dose vials and mean weight of the infants (both trials). Models 2 and 3, based on individual patient weights, assessed single-dose and multiple-use of single-dose vials cost scenarios, respectively. Individual patient weights allowed for statistical evaluation in Models 2 and 3.

Results: Model 1 savings with poractant alfa treatment was $949.67 (53%) based upon Speer and $617.90 (46%) based upon Ramanathan. Models 2 and 3 reported savings for poractant alfa of $220.50 (20%) (P = 0.11) and $180 (20%) (P = 0.018), respectively over beractant.

Conclusions: These analyses would suggest poractant alfa may offer a less costly, clinically-equivalent option. Savings may vary with vial usage and mix, patient weight distribution, and how surfactants are used in practice. Institutions utilizing surfactants may wish to examine usage patterns, dosing protocols, and patient mix to determine what potential savings may exist.