Cost-effectiveness analysis of palivizumab among pre-term infant populations covered by Medicaid in the United States

Weiner, Leonard B.; Masaquel, Anthony; Polak, Mark J.; Mahadevia, Parthiv J.

doi:10.3111/13696998.2012.672942

Cited by 39 publications

(33 citation statements)

References 71 publications

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“…24 Economic evaluations sponsored by the manufacturer of palivizumab suggest cost neutrality or even cost savings. [124][125][126][127][128][129][130][131][132][133][134] In contrast, analyses conducted by independent investigators consistently demonstrate the cost of palivizumab prophylaxis far exceeds the economic benefit of hospital avoidance, even among infants at highest risk. 24,25,[39][40][41][42]46,90,[135][136][137][138][139][140][141][142][143] Variation in results are explained by differences in study methodology and different base case assumptions used in the model, such as incidence of RSV hospitalization for different risk groups, effectiveness of prophylaxis in reducing hospitalization rate by risk group, estimates of cost of prophylaxis and RSV hospitalizations avoided, number of doses administered, estimated age and weight of infants, and inclusion of a theoretical benefit on mortality reduction.…”

Section: Cost Analysesmentioning

confidence: 89%

Updated Guidance for Palivizumab Prophylaxis Among Infants and Young Children at Increased Risk of Hospitalization for Respiratory Syncytial Virus Infection

Brady¹,

Byington²,

Davies³

et al. 2014

Pediatrics

312

170

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Guidance from the American Academy of Pediatrics (AAP) for the use of palivizumab prophylaxis against respiratory syncytial virus (RSV) was first published in a policy statement in 1998. Guidance initially was based on the result from a single randomized, placebo-controlled clinical trial conducted in 1996–1997 describing an overall reduction in RSV hospitalization rate from 10.6% among placebo recipients to 4.8% among children who received prophylaxis. The results of a second randomized, placebo-controlled trial of children with hemodynamically significant heart disease were published in 2003 and revealed a reduction in RSV hospitalization rate from 9.7% in control subjects to 5.3% among prophylaxis recipients. Because no additional controlled trials regarding efficacy were published, AAP guidance has been updated periodically to reflect the most recent literature regarding children at greatest risk of severe disease. Since the last update in 2012, new data have become available regarding the seasonality of RSV circulation, palivizumab pharmacokinetics, the changing incidence of bronchiolitis hospitalizations, the effects of gestational age and other risk factors on RSV hospitalization rates, the mortality of children hospitalized with RSV infection, and the effect of prophylaxis on wheezing and palivizumab-resistant RSV isolates. These data enable further refinement of AAP guidance to most clearly focus on those children at greatest risk.

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Section: Cost Analysesmentioning

confidence: 89%

Updated Guidance for Palivizumab Prophylaxis Among Infants and Young Children at Increased Risk of Hospitalization for Respiratory Syncytial Virus Infection

Brady¹,

Byington²,

Davies³

et al. 2014

Pediatrics

312

170

View full text Add to dashboard Cite

show abstract

“…[120] Recommendations for the use of palivizumab for prevention of RSV infections in high-risk infants have been published by the American Academy of Pediatrics [121] and been adopted by many national committees. Recently, cost effectiveness of palivizumab prophylaxis was demonstrated in very low birth weight infants [122,123] and those with BPD. [124] At least a Cochrane meta-analysis revealed evidence that palivizumab prophylaxis is effective in reducing the frequency of hospitalisations due to RSV infection, i.e.…”

Section: Review Articlementioning

confidence: 99%

Prematurity and the burden of influenza and respiratory syncytial virus disease

et al. 2015

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The particular burden of both viral diseases in preterm infants is dominated by RSV and its associated rehospitalizations during the first two years of life. Prophylactic measures include vaccination against influenza virus of family members and caregivers and active immunization starting at the age of 6 months, and monthly injections of palivizumab during the cold season to avoid severe RSV disease and its sequelae.

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“…age having equal or less than one risk factor [36]. A European cost-effectiveness study based on nationwide long-term epidemiologic data (including 1579 children hospitalized because of RSV LRTI during 16 seasons) from Austria confirmed these results for preterm infants below 33 weeks, those of 33 to 35 weeks of gestational age, those with BPD, and at least those with CHD; the latter demonstrating the lowest costs per quality-adjusted life years [37].…”

Section: Efficacy and Economic Aspects Of Palivizumabmentioning

confidence: 98%

Respiratory Syncytial Virus Infection in High-risk Infants – an Update on Palivizumab Prophylaxis

Resch

2014

TOMICROJ

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Morbidity due to respiratory syncytial virus (RSV) disease is still high in infants and children worldwide during the first two to five years of life. Certain categories of high-risk infants with increased morbidity and mortality attributed to RSV disease have been identified and are included in national recommendations for prophylaxis with the monoclonal RSV antibody palivizumab. Most guidelines recommend palivizumab for preterm infants born less than or equal to 32 weeks gestational age with or without bronchopulmonary dysplasia, those born between 33 and 35 weeks gestational age with additional risk factors, and infants and children with hemodynamically significant congenital heart disease. Over the last years several rare diseases have been identified demonstrating high morbidity associated with RSV disease, thus, extension of guidelines for the prophylaxis with palivizumab for these patients with rare diseases including children with malignancy, congenital and acquired immune deficiency, Down syndrome, neuromuscular impairment, cystic fibrosis, congenital diaphragmatic hernia and other severe respiratory disease is increasingly discussed. Efficacy of palivizumab prophylaxis is documented by meta-analysis, and different economic analyses demonstrate cost-effectiveness of palivizumab for the most common indications during the first RSV season.

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Cost-effectiveness analysis of palivizumab among pre-term infant populations covered by Medicaid in the United States

Cited by 39 publications

References 71 publications

Updated Guidance for Palivizumab Prophylaxis Among Infants and Young Children at Increased Risk of Hospitalization for Respiratory Syncytial Virus Infection

Updated Guidance for Palivizumab Prophylaxis Among Infants and Young Children at Increased Risk of Hospitalization for Respiratory Syncytial Virus Infection

Prematurity and the burden of influenza and respiratory syncytial virus disease

Respiratory Syncytial Virus Infection in High-risk Infants – an Update on Palivizumab Prophylaxis

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