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. 2022 Sep;36(5):696-705.
doi: 10.1111/ppe.12906. Epub 2022 Jul 13.

Economic costs and health utility values associated with extremely preterm birth: Evidence from the EPICure2 cohort study

Felix Achana  1   2 , Samantha Johnson  3 , Yanyan Ni  4   5 , Neil Marlow  4 , Dieter Wolke  2   5 , Kamran Khan  6 , Stavros Petrou  1
Affiliations

Economic costs and health utility values associated with extremely preterm birth: Evidence from the EPICure2 cohort study

Felix Achana et al. Paediatr Perinat Epidemiol. 2022 Sep.

Abstract

Background: Preterm birth is associated with adverse health and developmental sequelae that impose a burden on finite resources and significant challenges for individuals, families and societies.

Objectives: To estimate economic outcomes at age 11 associated with extremely preterm birth using evidence from a whole population study (EPICure2 study).

Methods: The study population comprised a sample of children born at ≤26 completed weeks of gestation during 2006 in England (n = 200) and a comparison group of classmates born at term (n = 143). Societal costs were estimated using parent and teacher reports of service utilisation, and valuations of work losses and additional care costs to families. Utility scores for the Health Utilities Index Mark 2 (HUI2) and Mark 3 (HUI3) were generated using UK and Canadian value sets. Generalised linear regression was used to estimate the impact of extremely preterm birth on societal costs and utility scores.

Results: Unadjusted mean societal costs that excluded provision of special educational support in mainstream schools during the 11th year after birth were £6536 for the extremely preterm group and £3275 for their classmates, generating a difference of £3262 (95% confidence interval [CI] £1912, £5543). The mean adjusted cost difference was £2916 (95% CI £1609, £4224), including special educational needs provision in mainstream schools increased the adjusted cost difference to £4772 (95% CI £3166, £6378). Compared with birth at term, extremely preterm birth generated mean-adjusted utility decrements ranging from 0.13 (95% CI 0.09, 0.18) based on the UK HUI2 statistical inference tariff to 0.28 (95% CI 0.18, 0.37) based on the Canadian HUI3 tariff.

Conclusions: The adverse economic impact of extremely preterm birth persists into late childhood. Further longitudinal studies conducted from multiple perspectives are needed to understand the magnitude, trajectory and underpinning mechanisms of economic outcomes following extremely preterm birth.

Keywords: costs; economic; extremely preterm; health utilities.

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Conflict of interest statement

SP receives support as a NIHR Senior Investigator (NF‐SI‐0616‐10103) and from the NIHR Applied Research Collaboration Oxford and Thames Valley. The views contained within this paper are those of the authors and not necessarily of the funders. NM declares Consulting fees with Novartis outside the published work and receives part funding from the Department of Health’s National Institute for Health Research Biomedical Research Centre’s funding scheme at UCLH/UCL. All other authors have no conflict of interest to report.

References

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