Cost Analysis of Treating Neonatal Hypoglycemia with Dextrose Gel

TitleCost Analysis of Treating Neonatal Hypoglycemia with Dextrose Gel
Publication TypeJournal Article
Year of Publication2018
AuthorsGlasgow, M., J. Harding, R. Edlin, J. M. Alsweiler, J. Chase, D. Harris, B. Thompson, T. Wouldes, J. Ansell, A. Jaquiery, K. Jones, S. Martin, C. McQuoid, J. Rogers, H. Stewart, A. Tottman, K. Williamson, E. Campbell, C. Bevan, T. Crawford, K. Fredell, K. Sommers, C. Hahnhaussen, S. Hossin, K. Frost, G. McKnight, J. Paynter, J. Wilson, R. Young, A. Gsell, J. Brosnahan, A. Timmings, A. Nair, A. Wallace, P. Weston, A. Le Compte, M. Signal, N. Austin, J. Armishaw, N. Webster, R. Haslam, P. Ashwood, L. Doyle, K. Callanan, I. Wright, H. Feldman, W. Hay, D. Wilson, and R. Hess
JournalJournal of Pediatrics
Volume198
Pagination151-155.e1
KeywordsArticle, birth, blood glucose monitoring, buccal mucosa, cesarean section, clinical outcome, comparative study, controlled study, cost, cost benefit analysis, cost control, Costs and Cost Analysis, decision tree, Decision Trees, double blind procedure, economics, female, gel, Gels, glucose, glucose blood level, glucose oxidase, health care cost, health care planning, health care utilization, health economics, Health Resources, human, Humans, hypoglycemia, Infant, Intensive Care, length of stay, major clinical study, Neonatal, neonatal intensive care unit, New Zealand, newborn, newborn intensive care, postnatal care, priority journal, randomized controlled trial, sweetening agent, Sweetening Agents, vaginal delivery
Abstract

Objective: To evaluate the costs of using dextrose gel as a primary treatment for neonatal hypoglycemia in the first 48 hours after birth compared with standard care. Study design: We used a decision tree to model overall costs, including those specific to hypoglycemia monitoring and treatment and those related to the infant's length of stay in the postnatal ward or neonatal intensive care unit, comparing the use of dextrose gel for treatment of neonatal hypoglycemia with placebo, using data from the Sugar Babies randomized trial. Sensitivity analyses assessed the impact of dextrose gel cost, neonatal intensive care cost, cesarean delivery rate, and costs of glucose monitoring. Results: In the primary analysis, treating neonatal hypoglycemia using dextrose gel had an overall cost of NZ$6863.81 and standard care (placebo) cost NZ$8178.25; a saving of NZ$1314.44 per infant treated. Sensitivity analyses showed that dextrose gel remained cost saving with wide variations in dextrose gel costs, neonatal intensive care unit costs, cesarean delivery rates, and costs of monitoring. Conclusions: Use of buccal dextrose gel reduces hospital costs for management of neonatal hypoglycemia. Because it is also noninvasive, well tolerated, safe, and associated with improved breastfeeding, buccal dextrose gel should be routinely used for initial treatment of neonatal hypoglycemia. Trial registration: Australian New Zealand Clinical Trials Registry: ACTRN12608000623392. © 2018 Elsevier Inc.

DOI10.1016/j.jpeds.2018.02.036