title: Changing costs and the impact on RSV prophylaxis.
abstract: OBJECTIVE
  Acquisition costs of palivizumab have increased in Canada since 2007. This analysis aims to re-evaluate the cost effectiveness of palivizumab in Canada for premature infants born between 32 and 35 weeks' gestational age using updated 2010 healthcare costs compared to those used in a 2007 decision analytic model.
  
  
  METHODS
  New costs (CAN$) were acquired from the same Health Canada and Ontario Ministry of Health sources that were utilized in the previously published 2007 model. Palivizumab prices were acquired from Abbott Laboratories Ltd., current as of August 2010.
  
  
  RESULTS
  Incremental cost-effectiveness ratios (ICERs) rose by $742, going from $30,618/QALY to $31,360/QALY. ICER changes increased from a range of $801,297 to $820,701 for infants with zero risk factors to a decrease from $808 to $192 for infants with four or more risk factors.
  
  
  CONCLUSIONS
  Palivizumab ICERs remained fairly stable from 2007 to 2010. The original recommendation stating that palivizumab is cost effective in infants born between 32 and 35 weeks' GA with two or more risk factors, or who are at moderate-to-high risk based on a risk assessment model, does not change. Analyses founded on evolving country-specific variables are needed in order to accurately reassess the cost effectiveness of interventions as costs change worldwide.
  
  
  CONCLUSIONS
  There are a limited number of publications reporting mortality in premature Canadian infants with RSV as a primary outcome. In addition, conclusions drawn from this analysis are country-specific and limited to premature infants dwelling in Canada.
authors.affiliation: Medical Outcomes and Research in Economics Group, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Smart
authors.forename: Bosco A
authors.initials: BA
authors.lastname: Paes
authors.forename: Krista L
authors.initials: KL
authors.lastname: Lanctôt
mesh_terms: D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000191:economics*; D061067:Antibodies, Monoclonal, Humanized; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000191:economics*; D002170:Canada; D018890:Chemoprevention; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D018803:Models, Economic; D000069455:Palivizumab; D018357:Respiratory Syncytial Virus Infections / Q000517:prevention & control*
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000998:Antiviral Agents; D000069455:Palivizumab