Cost-effectiveness of respiratory syncytial virus prophylaxis with palivizumab.
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.
Reeve
Carole A
CA
Department of Neonatology, The Townsville Hospital, Townsville, Queensland, Australia.
Whitehall
John S
JS
Buettner
Petra G
PG
Norton
Robert
R
Reeve
David M
DM
Francis
Fleur
F
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
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000998:Antiviral Agents; D000069455:Palivizumab