Purpose: Preterm births are disproportionately responsible for the medical costs of newborns. 17 alpha hydroxyprogesterone caproate (17P) has been shown to prevent preterm birth in pregnant women with a history of a prior spontaneous preterm delivery. Our objective is to assess the potential impact of 17P treatment on future medical costs.

Methods: Data on the costs of preterm birth were obtained from the medical literature and combined with published data on the effectiveness of 17P to estimate the expected reduction in medical costs from treating expectant mothers with prior preterm birth (PPTB). Information on drug dosage costs and nurse wages were obtained to approximate 17P treatment costs. Published estimates of the population eligible for treatment with 17P were used to estimate the reduction in national medical costs that could be achieved from universal 17P treatment of expectant mothers with PPTB.

Results: Administering 17P to expectant mothers with PPTB is predicted to reduce medical costs associated with initial hospitalization by $2800 to $2900. Lifetime (discounted) medical costs are predicted to decline by $15,600. The predicted savings greatly exceed the cost of a full 17P treatment regimen, approximated as $500. Even under conservative assumptions about the 17P treatment effect, treatment is predicted to reduce aggregate medical costs. If administered universally to expectancy mothers with PPTB, 17P would reduce U.S. medical costs by over $3 billion annually (calculated over the lifetime of affected offspring).

Conclusions: The use of 17 alpha hydroxyprogesterone caproate is not only effective for preventing preterm birth, but also for reducing future medical spending. Both public and private insurers should cover 17P treatments for women with PPTB, as the potential medical savings greatly exceed the cost of treatment, even in the short-term. Universal treatment of expectant mothers with a PPTB at would generate net medical savings (beyond the cost of treatment) in excess of $3 billion annually when calculated over the lifetimes of treated infants.