Implementation of a Palivizumab Order Panel to Decrease Inappropriate Use.

Area of Science:

• Pharmacoeconomics
• Infectious Disease Prevention
• Healthcare Policy

Background:

• Palivizumab is a critical monoclonal antibody for preventing respiratory syncytial virus (RSV) in high-risk infants.
• Previous evaluations indicated suboptimal prescribing of palivizumab, with 12% of uses not meeting established criteria.
• A need existed to improve the appropriateness of palivizumab utilization to ensure efficacy and manage costs.

Purpose of the Study:

• To evaluate the impact of a newly implemented electronic order panel and updated restriction policy on palivizumab prescribing practices.
• To determine if these interventions improved the adherence to established criteria for palivizumab use.
• To assess the subsequent effect on healthcare costs associated with palivizumab administration.

Main Methods:

• A retrospective medication use evaluation (MUE) compared palivizumab orders from two RSV seasons: pre-intervention (2015-2016) and post-intervention (2016-2017).
• Prescriber order data and patient charts were reviewed to verify adherence to approved palivizumab criteria.
• A chi-squared test was employed to statistically analyze the difference in inappropriate prescribing rates between the two seasons.

Main Results:

• Inappropriate palivizumab administrations decreased from 13.8% (11/80 orders) in the 2015-2016 season to 5.7% (4/70 orders) in the 2016-2017 season.
• This reduction in inappropriate use resulted in an estimated cost avoidance of $12,807.18.
• While a reduction in inappropriate orders was observed (8.1%), the change did not reach statistical significance (p = 0.102).

Conclusions:

• The implementation of an electronic order panel combined with a revised restriction policy effectively decreased the proportion of inappropriately administered palivizumab doses.
• These interventions led to significant cost savings, demonstrating the value of targeted policy changes in optimizing medication use.
• The study highlights the success of stewardship initiatives in improving adherence to evidence-based prescribing guidelines for high-cost biologics.