COLFOSCERIL PALMITATE - A PHARMACOECONOMIC EVALUATION OF A SYNTHETIC SURFACTANT PREPARATION (EXOSURF(R) NEONATAL(TM)) IN INFANTS WITH RESPIRATORY-DISTRESS SYNDROME

Comprehensive clinical data provide strong evidence of the efficacy of the synthetic lung surfactant colfosceril palmitate (Exosurf(R) Neona tal(TM)) administered as prophylaxis or rescue therapy in infants with respiratory distress syndrome (RDS). The nse of resale therapy with c olfosceril palmitate is further supported by cost-effectiveness analys es,which report a 9 to 48% reduction in the cost pel survivor compared with placebo or historical controls, despite divergent study methodol ogy and location. Importantly,: the savings,cere evident in both large r (greater than or equal to 1250g) and smaller (700 to 1350g) infants. All studies considered costs or charges accrued during initial hospit alisation through to I year; measurement of long term resource use dat a and all resulting costs are required for a more complete pharmacoeco nomic evaluation. The optimal timing of surfactant administration is l ikely to be an important economic issue given that efficacy data from a large international trial support earlier administration of colfosce ril palmitate versus delayed therapy in high risk patients. Ir, ther e conomic benefits may be realised by the sequential use of antenatal co rticosteroids and surfactant therapy, although this hers yet to be pro spectively investigated. In conclusion, clinical and pharmacoeconomic data strongly support the use of rescue therapy with colfosceril palmi tate. Additionally recent clinical data indicating that even better re sults may be achieved,vith earlier administration and/or combined use with antenatal corticosteroids should be assessed from an economic sta ndpoint to determine the optimal escribing strategy for this agent.