A new study by researchers at HSPH, working with colleagues at Baylor College of Medicine and the Mexican Ministry of Health, finds that expensive, intensive care that enables many preterm and low-birth-weight infants to survive is highly cost-effective in Mexico. The study was undertaken as part of a broader effort to evaluate an array of interventions for possible inclusion in Mexico’s Seguro Popular program, which offers free access to a set of health care interventions for 50 million people who lacked health insurance before the program.
HSPH’s Joshua Salomon, associate professor of international health, and colleagues estimated the clinical outcomes and costs of neonatal intensive care in Mexico using a mathematical model to combine the best available evidence from various sources. The paper was published online Dec. 14, 2010, in the journal PLoS Medicine. Sue Goldie, Roger Irving Lee professor of public health, is a coauthor on the study.
“Neonatal intensive care actually provides exceptionally high value for (the) money when you tally up all of the short-term and long-term health gains against the relatively high cost of the intervention itself,” Salomon said in a Dec. 17 interview with Voice of America. For example, he said, infants born about 15 weeks premature can expect to live 28 years longer if they receive intensive care compared with not receiving it, at a cost of $1,200 for each year of healthy life gained. Interventions that add years of healthy life at costs below a country’s per-capita income are considered highly cost-effective. Compared to Mexico’s gross domestic product (GDP) of $8,200 (U.S.) per capita, neonatal intensive care is therefore extremely cost-effective, even for the most preterm infants. The cost-effectiveness of intensive care becomes even more attractive as infants are born closer to full gestation.
Every year an estimated 4 million babies die in the first month of life, and 28% of those die from preterm birth. Most pregnancies last about 40 weeks, but an increasing number of infants in developed nations and some middle-income countries such as Mexico are born before 37 weeks gestation. These babies often survive, thanks to neonatal intensive care, but many do have cerebral palsy, deafness, learning difficulties or other physical or mental disabilities. This study finds that, even accounting for both high costs of intervention and the possibility of lifelong impairments, neonatal intensive care is highly efficient in terms of the overall benefits it provides compared to the resources it consumes.