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Published on: December 10, 2013
A cost-benefit analysis of RSV prophylaxis in high-risk infants
L M Schrand1, J M Elliott, M B Ross
1Department of Pharmaceutical Care, University of Iowa Hospitals and Clinics, Iowa City, USA. linda-schrand@uiowa.edu
Insights
Respiratory syncytial virus (RSV) prophylaxis with RSV-immunoglobulin (RSV-IG) and palivizumab significantly reduces hospitalization rates in high-risk infants. This preventative therapy proves cost-effective, saving healthcare dollars by averting costly RSV-related hospitalizations.
Area of Science:
- Pediatrics
- Infectious Diseases
- Health Economics
Background:
- Respiratory syncytial virus (RSV) is a leading cause of hospitalization in high-risk infants.
- Prophylactic therapies like RSV-immunoglobulin (RSV-IG) and palivizumab aim to prevent severe RSV-associated illness.
- Evaluating the economic impact of these prophylactic measures is crucial for healthcare resource allocation.
Purpose of the Study:
- To assess the cost-benefit of RSV-IG and palivizumab for RSV prophylaxis in high-risk infants.
- To compare the economic outcomes of prophylactic therapy versus no prophylaxis.
Main Methods:
- A retrospective cohort study compared infants receiving RSV-IG or palivizumab with eligible infants from a prior season who did not receive prophylaxis.
- Medical records were reviewed to collect data on drug administration costs and RSV hospitalization treatment expenses.
- Decision analysis and cost-benefit analysis were employed to evaluate the return on investment.
Main Results:
- Infants receiving prophylaxis had a significantly lower hospitalization rate (1.6%) compared to the unprophylaxed group (25%).
- The average cost per patient was lower in the prophylaxis group ($3,733) versus the unprophylaxed group ($4,258).
- The benefit-cost ratio was 1.15:1, indicating that the benefits of prophylaxis exceeded its costs.
Conclusions:
- RSV prophylaxis, when administered according to institutional criteria, provides significant benefits.
- The program demonstrates cost-effectiveness by preventing RSV-related hospitalizations and saving healthcare expenditures.
- Prophylaxis is a valuable intervention for reducing the burden of RSV illness in high-risk infant populations.
Objective:
To determine the cost and benefit of using RSV-IG and palivizumab as prophylactic therapy against respiratory syncytial virus (RSV)-associated illness in high-risk infants.
Methods:
A nonrandomized, retrospective, cohort control study was conducted comparing the outcomes of patients who received either RSV-IG or palivizumab therapy against RSV during the 1998-1999 RSV season with patients identified from the 1994-1995 RSV season who would have been eligible to receive prophylaxis had either agent been available at that time. Medical record reviews were conducted to gather data regarding the costs associated with both the administration of the prophylactic drugs and the treatment of RSV-associated hospitalizations in both groups. Decision analysis was used to determine the average cost per patient for both groups. A cost-benefit analysis was then conducted to determine the return on investment, if any, for the use of these drugs. A sensitivity analysis was also conducted to determine the robustness of the data.
Results:
Patients who received RSV-IG or palivizumab had a hospitalization rate of 1.6% compared with 25% for the group who did not receive prophylactic drugs. The average costs for the RSV prophylaxis group were less per patient $3,733 compared with $4,258 in the group who did not receive prophylaxis. The benefit is a 23.4% lower chance of hospitalization for each infant or, in dollar figures, $3,985 ($17,031 x 0.234). The benefit-cost ratio is 1.15:1 ($3,985:3,461). The benefits, therefore, exceed the costs associated with the prophylaxis program. The prophylaxis program saved healthcare dollars by preventing RSV-related hospital-izations.
Conclusions:
Results demonstrate that when used according to our institution's criteria, RSV prophylaxis is of benefit to our institution.
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