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Palivizumab coverage rates among moderate-to-late preterm infants in Korea: a nationwide cross-sectional study
Seungyeon Kim1, Saram Lee2,3,4, Young June Choe5
1College of Pharmacy, Dankook University, cheonan, Korea.
Insights
Palivizumab coverage for moderate-to-late preterm infants in Korea was low at 42.2% despite a national program. Targeted policies are needed to improve respiratory syncytial virus (RSV) prophylaxis, especially for higher-risk infants.
Area of Science:
- Pediatrics
- Public Health
- Neonatology
Background:
- Korea implemented a national palivizumab reimbursement program for moderate-to-late preterm (MLPT) infants in 2016.
- Respiratory syncytial virus (RSV) prophylaxis is crucial for vulnerable infants during the October-March season.
- Limited data exist on palivizumab coverage rates and influencing factors in MLPT infants.
Purpose of the Study:
- To evaluate palivizumab coverage rates in MLPT infants under the national reimbursement program.
- To identify factors associated with palivizumab administration in eligible MLPT infants.
Main Methods:
- Nationwide, population-based cross-sectional study using Korean National Health Insurance Service data (Oct 2016 - Mar 2019).
- MLPT infants were categorized into palivizumab administration and non-administration groups.
- Multivariate logistic regression analyzed factors influencing palivizumab administration.
Main Results:
- Overall palivizumab coverage was 42.2% (1,201/2,843 eligible infants).
- Coverage rates increased annually but remained suboptimal.
- Lower coverage was associated with higher gestational age, female sex, absence of low birth weight, March birth, non-capital residency, no NICU admission, and maternal age <35 years.
Conclusions:
- The initial 3 RSV seasons showed low palivizumab coverage (42.2%) for MLPT infants in Korea.
- National policies should target infants with higher gestational ages, March births, and those in non-capital areas.
- Improved coverage is essential for equitable RSV prophylaxis in MLPT infants.
Objectives:
Since October 2016, Korea has implemented a national reimbursement program for palivizumab aimed at moderate-to-late preterm (MLPT) infants born between 32 0/7 weels and 35 6/7 weeks of gestation during the respiratory syncytial virus (RSV) season (October-March). However, large-scale data on coverage rates and associated factors remain limited. This study evaluated palivizumab coverage rates and identified predictive factors influencing its administration in MLPT infants.
Methods:
This nationwide, population-based cross-sectional study utilized data from the Korean National Health Insurance Service collected between October 2016 and March 2019. MLPT infants eligible for palivizumab reimbursement were divided into administration and non-administration groups. Seasonal and overall coverage rates were assessed. A multivariate logistic regression analysis examined factors associated with palivizumab administration, with a focus on infant and maternal characteristics.
Results:
Among 2,843 eligible MLPT infants, 1,201 (42.2%) received palivizumab, while 1,642 (57.8%) did not. Although coverage rates increased annually, they remained suboptimal. Lower palivizumab prophylaxis coverage was observed in infants with higher gestational ages, female sex, absence of low birth weight, those born in March, residents of non-capital areas, infants not admitted to a neonatal intensive care unit at birth, and infants of mothers aged <35 years.
Conclusions:
In the initial 3 RSV seasons following the introduction of palivizumab reimbursement for MLPT infants in Korea, the overall coverage rate was low (42.2%). National policies targeting infants with higher gestational ages, those born in March, and those residing in non-capital areas are necessary to improve coverage and ensure equitable RSV prophylaxis.
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