WHO ACTION-I Trial in Low Resource Countries
2022
This study evaluated the cost-effectiveness of dexamethasone administration in dexamethasone in pregnant women at risk of early preterm birth using data from a multicentre, randomized, placebo-controlled trial in Bangladesh, India, Kenya, Nigeria, and Pakistan. Primary cost data were collected in 28 hospitals across the 5 countries. A decision tree model was used to compare dexamethasone treatment to no intervention from a health-care sector perspective. Administration of dexamethasone averted 38 neonatal deaths per 1000 woman–baby units and 1132 DALYs per 1000 woman–baby units. Compared with no intervention, use of antenatal corticosteroids was cost-saving in all five countries, ranging from a saving of US$1778 per 1000 woman–baby units (95% uncertainty interval [UI] –13 878 to 9483) in Nigeria to $53 681 per 1000 woman–baby units (–113 822 to 2394) in Kenya. Findings remained consistent following sensitivity analyses.
The authors also developed a Microsoft Excel-based calculator in which users can modify inputs for key model parameters to reflect their country or healthcare setting.
WHO ACTION-I Trial in Low Resource Countries
Source:
WHO ACTION Trial Collaborators. Antenatal Dexamethasone for Improving Preterm Newborn Outcomes in Low-Resource Countries: A Cost-Effectiveness Analysis of the WHO ACTION-I Trial. The Lancet Global Health 2022; 10 (10): E1523-E1533. https://doi.org/10.1016/S2214-109X(22)00340-0