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Cost-effectiveness analysis of palivizumab in premature infants without chronic lung disease

Nahed O Elhassan1, Melony E S Sorbero, Caroline B Hall

  • 1Division of Neonatology, Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, USA.

Archives of Pediatrics & Adolescent Medicine
|October 5, 2006
PubMed

Insights

Palivizumab prophylaxis for premature infants is generally not cost-effective for preventing respiratory syncytial virus. However, it may be cost-effective for some infants if severe asthma risk is considered.

Area of Science:

  • Pediatric infectious diseases
  • Health economics
  • Respiratory medicine

Background:

  • Respiratory syncytial virus (RSV) is a common cause of lower respiratory tract infections in infants.
  • Palivizumab is an antibody used for RSV prophylaxis in high-risk infants.
  • The cost-effectiveness of palivizumab in premature infants without chronic lung disease requires evaluation.

Purpose of the Study:

  • To assess the cost-effectiveness of palivizumab for RSV prophylaxis in premature infants.
  • To determine the impact of reduced asthma risk on palivizumab's cost-effectiveness.

Main Methods:

  • Two decision analytic models were used: one including and one excluding the risk of asthma post-RSV infection.
  • Hypothetical cohorts of premature infants (26-32 weeks gestation) without chronic lung disease were analyzed.
  • Cost-effectiveness was measured by the incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year (QALY).

Main Results:

  • Palivizumab prophylaxis incurred higher costs than no prophylaxis.
  • ICERs were generally high, exceeding the $200,000/QALY threshold, indicating limited cost-effectiveness.
  • Models were sensitive to palivizumab cost and the quality of life impact of childhood asthma.

Conclusions:

  • The study suggests more restrictive guidelines for palivizumab prophylaxis.
  • Palivizumab demonstrated cost-effectiveness for certain infants when severe asthma risk following RSV infection was factored into the analysis.
Abstract

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