Custo-efetividade do óxido nítrico inalatório no tratamento da hipertensão pulmonar persistente do recém-nascido.

Abstract

Persistent Pulmonary Hypertension of the Newborn (PPPN or PPHRN) is a clinical syndrome characterized by severe hypoxemia, lability of oxygenation with minimal handling and generalized cyanosis, defined by the presence of high pulmonary vascular resistance and right to-left shunt through the ductus arteriosus and/ or foramen ovale. This disease is associated with high morbidity rates, mainly due to neurological damage in 15 to 20% of cases. The treatment of this pathology must be carried out in the Neonatal Intensive Care Unit and consists of decreasing pulmonary vascular resistance in the use of pulmonary vasodilators, the gold standard treatment being the use of inhaled nitric oxide (iNO), which has a high cost and the possibility of therapeutic failure. The aim of this study was to analyze the cost-effectiveness of using inhaled nitric oxide in the treatment of PPHN compared to standard care offered by SUS. A cost-effectiveness evaluation (ACE) was carried out in a decision tree analytical model, based on secondary data, and with the help of the statistical program TreeAge Pro Healthcare, the calculation of the incremental cost-effectiveness ratio was performed. When calculating the ICER, treatment with iNO had a cost of R$13,585.47 per life saved and a cost of R$240.50 per potential life years gained compared to treatment without iNO. The results obtained demonstrate that nitric oxide therapy in neonates is more cost-effective.