Curosurf (poractant alfa) for the Treatment of Infants At Risk For or Experiencing Respiratory Distress Syndrome: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines [Internet]

The leading cause of respiratory distress syndrome in premature infants is the lack of surfactant. Surfactant is secreted by the cells in pulmonary alveoli and decrease the surface tension in the aveoli. The secretion of surfactant in fetus lungs begins at the third trimester of pregnancy. With surfactant, the alveoli are less likely to collapse at low lung volume. When infants are at risk of developing or have developed respiratory distress due to the lack of surfactant, surfactant can be supplemented externally for prophylaxis or treatment purposes. For its importance in reducing mortality and morbidity in infants, surfactant is currently listed on the World Health Organization Model List of Essential Medicines, the essential and basic medications needed in health care.

There is some evidence that porcine-derived surfactant, poractant alfa, may be more effective than the bovine-derived calfactant in reducing deaths, need for oxygen, and mechanical ventilation. However, the price of poractant alfa is higher and may not be costeffective in clinical practice compared to bovine-derived alternatives. For policymaking in health care, the adoption of interventions in medical practice requires considerations in clinical effectiveness and cost-effectiveness. This review aims to systematically assess the clinical effectiveness and cost-effectiveness of poractant alfa, compared to bovine-derived surfactants.