Pih22 Caress: The Canadian Registry of Synagis(®)

Lanctôt, KL; Mitchell, Ian; Paes, B; Reim, EK

doi:10.1016/s1098-3015(10)70795-6

Cited by 2 publications

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“…However, the distribution of children meeting eligibility criteria in our study was comparable to the Canadian Registry of Synagis (CARESS) (online supplementary table 4). 39 Further, in 2015/2016, 3119 children received palivizumab in Ontario; 40 nearly 2000 children would have been clearly palivizumab-eligible in our study. Moreover, even though we included all severe RSV-related illness among all children born in Canada's largest province over multiple decades, we may lack power to detect true differences within eligible groups, particularly older children for which RSV events were rare and few are palivizumab-eligible.…”

Section: Discussionmentioning

confidence: 79%

Palivizumab’s real-world effectiveness: a population-based study in Ontario, Canada, 1993–2017

et al. 2020

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ObjectiveTo evaluate the effectiveness of two palivizumab programmes targeting high-risk infants, defined by prematurity, diagnosis of comorbidities and geography, and assess potential disparities by neighbourhood income.DesignControlled, interrupted time series.SettingOntario, Canada.PatientsWe used linked health and demographic administrative databases to identify all children born in hospitals 1 January 1993 through 31 December 2016. Follow-up ended at the earliest of second birthday or 30 June 2017.InterventionPalivizumab-eligibility: child was born very preterm and ≤6 months old during respiratory syncytial virus (RSV) season; <24 months old with significant chronic lung or congenital heart disease; or ≤6 months, born preterm or residents of remote regions.Main outcomeSevere RSV-related illness, defined as hospitalisation or death with a diagnosis of bronchiolitis, RSV pneumonia or RSV.Results3 million births and 87 000 RSV-related events were identified. Over the study period, rates of severe RSV-related illness declined 65.4% among the highest risk group, eligible infants <6 months (230.6 to 79.8 admissions per 1000 child-years). Relative to changes among ineligible infants <6 months, rates dropped 10.4% (95% CI −18.6% to 39.4%) among eligible infants immediately following introduction of a national palivizumab programme in 1998. Initially, rates were considerably higher among infants from low-income neighbourhoods, but income-specific rates converged over time among eligible infants <6 months; such convergence was not seen among other children.ConclusionsIncidence of severe RSV-related illness declined over the study period. While we cannot attribute causality, the timing and magnitude of these declines suggest impact of palivizumab in reducing RSV burden and diminishing social inequities among palivizumab-eligible infants.

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Section: Discussionmentioning

confidence: 79%

Palivizumab’s real-world effectiveness: a population-based study in Ontario, Canada, 1993–2017

et al. 2020

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“…Wastage costs were calculated as per the World Health Organization (WHO) recommendations (28). The weighted average price of palivizumab was calculated to be $1,227 per dose, with 36.96% of infants receiving the 50 mg vial at a cost of $752 per dose and 63.04% receiving the 100 mg vial for $1,505 per dose (25,(29)(30)(31). The cost of administration for vaccine or monoclonal antibodies was set to $14.70 per dose, with each administration considered a new visit (32).…”

Section: Costsmentioning

confidence: 99%

Cost-effectiveness of RSVpreF vaccine and nirsevimab for the prevention of respiratory syncytial virus disease in Canadian infants

Gebretekle,

Yeung,

Ximenes

et al. 2024

Preprint

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BackgroundHealth Canada recently authorized the RSVpreF pregnancy vaccine and nirsevimab to protect infants against respiratory syncytial virus (RSV) disease.ObjectiveAssess the cost-effectiveness of RSVpreF and nirsevimab programs in preventing RSV disease in infants, compared to a palivizumab program.MethodsWe used a static cohort model of a Canadian birth cohort during their first RSV season to estimate sequential incremental cost-effectiveness ratios (ICERs) in 2023 Canadian dollars per quality-adjusted life year (QALY) for nine strategies implemented over a one-year time period, from the health system and societal perspectives. Sensitivity and scenario analyses were conducted to explore the impact of uncertainties on the results.ResultsAll-infants nirsevimab programs averted more RSV-related outcomes than year-round RSVpreF programs, with the most RSV cases averted in seasonal nirsevimab programs. Assuming list prices for these immunizing agents, all-infants nirsevimab and year-round RSVpreF programs were never cost-effective, with ICERs far exceeding commonly used cost-effectiveness thresholds. Seasonal nirsevimab with catch-up was cost-effective if prioritized for infants at moderate/high-risk (ICER <$28,000 per QALY) or those living in settings with higher RSV burden and healthcare costs (ICER of $5,700 per QALY). Using a $50,000 per QALY threshold, an all-infants nirsevimab program could be optimal if nirsevimab is priced at <$110-190 per dose. A year-round RSVpreF for all pregnant women/pregnant people plus nirsevimab for infants at high-risk was optimal if nirsevimab is priced at >$110-190 and RSVpreF priced at <$60-125.InterpretationProphylactic interventions can substantially reduce RSV disease in infants, and targeted nirsevimab programs are the most cost-effective option at current product prices.

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Pih22 Caress: The Canadian Registry of Synagis(®)

Cited by 2 publications

References 0 publications

Palivizumab’s real-world effectiveness: a population-based study in Ontario, Canada, 1993–2017

Palivizumab’s real-world effectiveness: a population-based study in Ontario, Canada, 1993–2017

Cost-effectiveness of RSVpreF vaccine and nirsevimab for the prevention of respiratory syncytial virus disease in Canadian infants

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