Cost-effectiveness of palivizumab against respiratory syncytial viral infection in high-risk children in Austria.
OBJECTIVE
The aim of this study was to estimate the cost-effectiveness of palivizumab, a monoclonal antibody against severe respiratory syncytial virus infection, in high-risk infants in Austria.


METHODS
A decision tree model was developed to determine cost-effectiveness in infants born prematurely (<or=35 weeks' gestational age), those with bronchopulmonary dysplasia (BPD), and children with congenital heart disease (CHD). The primary perspective of the analysis was that of the compulsory health insurance fund. The societal perspective was also considered.


RESULTS
From the health insurance fund perspective, including the costs associated with asthma, the incremental cost-effectiveness ratio (cost per quality-adjusted life year [QALY] gained) without discounting was estimated to be euro 4484 (2006 euros) in preterm infants, euro 6719 in children with BPD, and euro 2668 in the CHD population. When discounted, these figures increased to euro 14,439, euro 21,672, and euro 9754, respectively. The results from the societal perspective were substantially more cost-effective in all populations. The undiscounted cost per QALY was euro 1435 in preterm infants, euro 4881 in children with BPD, and euro 251 in the CHD group. Discounted figures were euro 4623, euro 15,741, and euro 917, respectively. Sensitivity analyses confirmed the robustness of the model, and scenario analyses found that the inclusion of indirect costs led to further improvement in the cost-effectiveness outcomes for palivizumab.


CONCLUSIONS
Use of palivizumab was cost-effective compared with no prophylaxis in high-risk infants and children in Austria.
Resch
Bernhard
B
Department of Pediatrics, University Hospital Graz, Graz, Austria.
Gusenleitner
Walter
W
Nuijten
Mark J C
MJ
Lebmeier
Maximilian
M
Wittenberg
Wolfgang
W
D000911:Antibodies, Monoclonal / Q000191:economics* / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000998:Antiviral Agents / Q000191:economics* / Q000627:therapeutic use*; D001317:Austria / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D008017:Life Expectancy; D000069455:Palivizumab; D011379:Prognosis; D018357:Respiratory Syncytial Virus Infections / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000998:Antiviral Agents; D000069455:Palivizumab