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PEDIATRICS Vol. 113 No. 6 June 2004, pp. 1849-1851

Inhaled Nitric Oxide and the Societal Perspective

Thor Willy Ruud Hansen, MD, PhD, MHA, FAAP
Section on Neonatology, Department of Pediatrics
Rikshospitalet
University of Oslo
Oslo, Norway

The first 300 words of the full text of this article appear below.

Three articles in the December issue of Pediatrics provide fascinating and at the same time disturbing reading. Angus et al,1 from Pittsburgh, Pennsylvania, studied the cost-effectiveness of inhaled nitric oxide (iNO) in the treatment of neonatal respiratory failure, and Field et al2 provide a commentary on their article. The third article that caught my attention was "Annual Summary of Vital Statistics—2002,"3 which shows that, in spite of its huge investment in health care, the United States continues to lag behind most of the industrialized world and even some developing countries as far as infant mortality rates.

The study by the Pittsburgh group1 and the Field et al commentary2 are fascinating, because they show that, even in science, it is possible to look at facts from such different vantage points that the realities one perceives are literally "worlds apart." These 2 articles are deeply disturbing also because they document that accepting support from industry sources, as appropriately acknowledged both by Field et al and Angus et al, can so narrow your field of vision that the forest disappears and all you see is a lone tree.

The Pittsburgh group concludes that "from a US societal perspective, iNO has a favorable cost-effectiveness profile...,"1 whereas Field et al conclude that the Pittsburgh study "goes some way to justifying the use of NO at the present price."2 To wit, the cost of the iNO they are talking about is INOmax from INO Therapeutics. I suspect champagne corks were flying at INO Therapeutics' headquarters when these 2 articles appeared. The rest of us, as I shall discuss, may have less reason to be pleased.

Field et al2 provide some critique of "assumptions that are not . . . [Full Text of this Article]


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