COSTING NEONATAL CARE ALONGSIDE THE COLLABORATIVE ECMO TRIAL - HOW MUCH PRIMARY RESEARCH IS REQUIRED

Researchers working on economic evaluations alongside trials have to b alance minimising data collection with maximising the ability to measu re differences in costs. Using existing data sources may keep the cost s of research down, but these data may not be entirely appropriate to the evaluation question. When evaluating technologies in intensive car e it is particularly important to be able to classify patients correct ly by their resource requirements especially when those requirements v ary considerably from day to day. This paper describes and justifies m ethods for costing the care provided for babies in (one arm of) an on- going multi-centre trial, the Collaborative ECMO trial.(1) This trial is evaluating alternative policies of life support for mature (full te rm) newborn babies with severe respiratory failure. The most reliable cost information on neonatal intensive care is available from a study, conducted independently from the trial, which has used simple cost ap portionment on a large sample of units. By drawing on clinical opinion and carrying out a case note exercise we assessed whether this availa ble information was appropriate to estimate 'baseline' costs for the c ontrol group during their initial 'acute' phase of illness. We conclud ed that the available cost estimates would need to be weighted to refl ect the additional costs of drugs and investigations for this group of babies during the acute phase. Multidisciplinary collaboration on tri als can help economists and other researchers to balance the requireme nt for simple cost measurements with more detailed primary research.