title: Cost-effectiveness of respiratory syncytial virus prophylaxis with palivizumab.
abstract: BACKGROUND
  A monoclonal antibody, palivizumab, directed against respiratory syncytial virus (RSV) has been shown to decrease hospitalisation rates. Because of its expense, the cost-effectiveness of this agent should be determined for high-risk groups.
  
  
  OBJECTIVE
  To determine characteristics of RSV infection in Townsville and the economic feasibility of palivizumab immunoprophylaxis in high-risk groups.
  
  
  METHODS
  Cases of RSV-positive bronchiolitis were retrospectively identified. Cases were grouped according to recognised risk factors. The hypothetical costs of palivizumab immunoprophylaxis for infants at risk were calculated.
  
  
  RESULTS
  The rate of hospitalisation with RSV-positive lower respiratory tract infection was 22 per 1000 live births but increased to 50 per 1000 among Indigenous babies born weighing <2500 g. The cost of preventing an admission in each of the identified high-risk groups, based on drug costs alone, ranged from AD 69,861 to AD 88,547.
  
  
  CONCLUSIONS
  Palivizumab was not cost-effective in the prophylaxis of RSV in the high-risk group of infants tested here.
authors.affiliation: Department of Neonatology, The Townsville Hospital, Townsville, Queensland, Australia.
authors.forename: Carole A
authors.initials: CA
authors.lastname: Reeve
authors.forename: John S
authors.initials: JS
authors.lastname: Whitehall
authors.forename: Petra G
authors.initials: PG
authors.lastname: Buettner
authors.forename: Robert
authors.initials: R
authors.lastname: Norton
authors.forename: David M
authors.initials: DM
authors.lastname: Reeve
authors.forename: Fleur
authors.initials: F
authors.lastname: Francis
mesh_terms: D000911:Antibodies, Monoclonal / Q000191:economics / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000998:Antiviral Agents / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D018803:Models, Economic; D000069455:Palivizumab; D010343:Patient Admission / Q000706:statistics & numerical data; D011292:Premedication / Q000191:economics*; D011793:Queensland / Q000453:epidemiology / Q000208:ethnology; D018357:Respiratory Syncytial Virus Infections / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control*; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D012189:Retrospective Studies; D012621:Seasons
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000998:Antiviral Agents; D000069455:Palivizumab