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Cost effectiveness of a protocol using palivizumab in preterm infants

Yolanda Hernández-Gago1, Marina Lombardero-Pin1, Casilda Ortega de la Cruz2

  • 1Servicio de Farmacia del Complejo Hospitalario Universitario Insular Materno Infantil Canarias. Avd. Marítima del Sur s/n; 35016, Las Palmas de Gran Canaria.. yhergag@gobiernodecanarias.org.

Farmacia Hospitalaria : Organo Oficial De Expresion Cientifica De La Sociedad Espanola De Farmacia Hospitalaria
|February 27, 2017
PubMed

Insights

The consensus protocol for palivizumab (an antiviral medication) did not significantly increase hospitalizations for preterm infants under 32 weeks gestational age. However, it showed a higher hospitalization rate and unfavorable cost-effectiveness for infants under 35 weeks.

Area of Science:

  • Pediatric Infectious Diseases
  • Health Economics
  • Respiratory Syncytial Virus (RSV) Prevention

Background:

  • Palivizumab is used to prevent Respiratory Syncytial Virus (RSV) in high-risk infants.
  • Hospital consensus protocols aim to optimize palivizumab use based on scientific recommendations.
  • Evaluating the cost-effectiveness of such protocols is crucial for healthcare resource allocation.

Purpose of the Study:

  • To evaluate the cost-effectiveness of a hospital's consensus-based palivizumab protocol.
  • To compare the protocol's effectiveness against recommendations from various scientific societies.
  • To analyze risk factors and severity in hospitalized infants under the established protocol.

Main Methods:

  • Retrospective (4 seasons) and prospective (2 seasons) data collection comparing expanded vs. restricted palivizumab protocols.
  • Health system perspective, including hospitalization and palivizumab costs.
  • Effectiveness measured by admission rates in premature infants stratified by gestational age (<29, <32, <35 weeks).

Main Results:

  • No significant increase in effectiveness for gestational age <29 and <32 weeks compared to consensus.
  • Increased effectiveness observed for gestational age <35 weeks, with an incremental cost-effectiveness ratio (ICER) of €53,250.07 - €50,525.53.
  • The consensus protocol resulted in average seasonal savings of €169,911.51; cost-effectiveness is favorable if palivizumab cost is <€1,206.67 and hospitalization rate is >9.21%.

Conclusions:

  • The consensus protocol did not significantly increase hospitalization rates in preterm infants <32 weeks gestational age.
  • A higher hospitalization rate was observed in infants <35 weeks, with unfavorable cost-effectiveness across clinical scenarios.
  • Many infants admitted under the new protocol (seasons 12/13, 13/14) were under 3 months, term infants, or had various risk factors not typically targeted by standard guidelines.
Abstract

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