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Cost-effectiveness of respiratory syncytial virus prophylaxis in various indications

Christian Hampp1, Teresa L Kauf, Arwa S Saidi

  • 1Division of Epidemiology, Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD 20993, USA. christian.hampp@fda.hhs.gov

Archives of Pediatrics & Adolescent Medicine
|February 9, 2011
PubMed

Insights

Palivizumab immunoprophylaxis for respiratory syncytial virus (RSV) is not cost-effective, as its high cost significantly outweighs the economic benefits of preventing hospitalizations. This holds true even for high-risk pediatric populations.

Area of Science:

  • Pediatric Infectious Diseases
  • Health Economics
  • Public Health Policy

Background:

  • Respiratory syncytial virus (RSV) is a major cause of hospitalization in young children.
  • Palivizumab is an immunoprophylactic agent used to prevent RSV infections.
  • Evaluating the cost-effectiveness of medical interventions is crucial for resource allocation.

Purpose of the Study:

  • To assess the cost-effectiveness of palivizumab immunoprophylaxis for RSV prevention.
  • To analyze costs based on actual expenditures and observed incidence rates.
  • To stratify analysis across different pediatric risk groups.

Main Methods:

  • Decision tree analysis comparing palivizumab prophylaxis versus no prophylaxis.
  • Inclusion of pediatric risk factors: chronic lung disease, congenital heart disease, prematurity (≤32 weeks gestation).
  • Sensitivity analyses and Monte Carlo simulations to assess parameter uncertainty.

Main Results:

  • The cost per dose of palivizumab varied by age, ranging from $1661 to $2584.
  • Preventing one RSV hospitalization in preterm infants cost $302,103.
  • Cost-effectiveness ratios ranged from $361,727 to over $1.3 million per hospitalization avoided, with younger age and multiple indications showing better ratios.

Conclusions:

  • The cost of palivizumab immunoprophylaxis substantially exceeds the economic value of preventing RSV hospitalizations.
  • Even for the highest-risk infants, the intervention's cost-effectiveness is unfavorable.
  • Current pricing structures render palivizumab an economically inefficient strategy for RSV prevention.
Abstract

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