Palivizumab for Infants < 29 Weeks in Hong Kong without a Clear-Cut Season for Respiratory Syncytial Virus...

Area of Science:

• Pediatrics
• Public Health
• Health Economics

Background:

• Respiratory syncytial virus (RSV) poses a significant threat to premature infants, leading to high hospitalization rates.
• Palivizumab is a monoclonal antibody used for RSV prophylaxis, but its cost-effectiveness in specific preterm populations requires evaluation.

Purpose of the Study:

• To assess the cost-effectiveness of palivizumab prophylaxis for preterm infants born before 29 weeks gestation in Hong Kong.
• To analyze hospitalization rates and incremental cost-effectiveness ratios (ICER) for RSV infection prevention.

Main Methods:

• A retrospective cohort study evaluated preterm infants born between 2010 and 2014 at two Hong Kong hospitals.
• Hospitalization rates for RSV infection within 12 months of discharge were compared between infants who received palivizumab and those who did not.
• ICER per hospital admission prevented (ICER/HAP) was calculated for different gestational age subgroups.

Main Results:

• Palivizumab use was associated with a reduction in RSV hospitalization rates from 15.8% to 5% for infants <29 weeks (p=0.096) and from 33.3% to 8.7% for infants <27 weeks (p=0.046).
• The ICER/HAP was USD 24,365 for infants <29 weeks.
• The ICER/HAP was USD 3,108 for infants <27 weeks, indicating a more favorable cost-effectiveness.

Conclusions:

• Palivizumab prophylaxis demonstrates a more favorable cost-effectiveness for preventing RSV hospitalizations in extremely preterm infants born before 27 weeks gestation compared to those born before 29 weeks.
• These findings support targeted use of palivizumab in the most vulnerable preterm populations to optimize resource allocation in RSV prevention strategies.