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Updated: May 14, 2026
An In vitro Model to Study Immune Responses of Human Peripheral Blood Mononuclear Cells to Human Respiratory Syncytial Virus Infection
Published on: December 10, 2013
Should respiratory care in preterm infants include prophylaxis against respiratory syncytial virus? The case against
Insights
Palivizumab can reduce hospital admissions for preterm infants with respiratory syncytial virus (RSV). However, its high cost and limited cost-effectiveness mean it should only be used when proven beneficial for specific cases.
Area of Science:
- Pediatrics
- Infectious Diseases
- Health Economics
Background:
- Preterm infants face a higher risk of severe respiratory syncytial virus (RSV) infections.
- Palivizumab, a monoclonal antibody, is used for RSV prophylaxis in preterm infants.
- Current data indicates palivizumab is not consistently cost-effective for public funding.
Discussion:
- Palivizumab requires monthly intramuscular injections for five months.
- Preventing one hospital admission necessitates treating 17 infants; preventing one ICU admission requires treating 59.
- The high cost of palivizumab presents an opportunity cost, diverting funds from potentially more effective healthcare interventions.
Key Insights:
- Cost-effectiveness analyses have not definitively supported public funding for palivizumab.
- Palivizumab's cost-effectiveness is contingent on significant price reduction.
- The current economic profile suggests limited value for widespread prophylactic use.
Outlook:
- Future cost-effectiveness may improve with decreased palivizumab pricing.
- Further research is needed to identify specific subgroups where palivizumab demonstrates clear value.
- Clinical guidelines should prioritize evidence-based, cost-effective interventions for preterm infants.
Abstract:
Preterm infants are at increased risk of severe respiratory syncytial virus (RSV) infection. The monoclonal antibody palivizumab reduces the frequency of preterm infants being admitted to hospital with RSV infection. However, palivizumab is expensive, has to be given by intramuscular injection monthly for 5 months and has to be given prophylactically to 17 preterm children to prevent one hospital admission with RSV and to 59 children to prevent one intensive care admission. Cost-effectiveness analyses have not shown that palivizumab is cost-effective for any sub-group with sufficient certainty to recommend its public funding. Palivizumab will only be cost-effective if the price drops. Paying for palivizumab is an opportunity cost; the money could be spent better on other more cost-effective health care interventions. Palivizumab should not be prescribed for any preterm child unless it can be shown to be cost-effective in that situation.
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