Respiratory syncytial virus prophylaxis: cost-effective analysis in Argentina

Fariña, Diana; Rodríguez, Susana; Bauer, Gabriela; Novali, Luis; Bouzas, Liliana; Gonzalez, Helena; Gilli, C; Laffaire, Enrique

doi:10.1097/00006454-200204000-00006

Cited by 47 publications

(22 citation statements)

References 13 publications

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“…While these analyses have varied, all have questioned the costeffectiveness of the initial American Academy of Pediatrics recommendations. [18][19][20][21][22][23][24] In many of these analyses, given its high cost, the infants for whom palivizumab was most likely to be costeffective were those with gestational age <29 weeks gestation and/or those with chronic lung disease. While an analysis of the number of doses of palivizumab given from 1998 to 2000 is beyond the scope of this study, the current data suggest that a study of the impact of palivizumab on numbers of hospitalizations of premature infants for RSV infection is warranted.…”

Section: Discussionmentioning

confidence: 99%

Cost, causes and rates of rehospitalization of preterm infants

Danielsen²,

2007

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Objective: To examine hospital readmissions for premature infants during the first year of life.Study Design: The California maternal and newborn/infant hospital discharge records were examined for subsequent readmission during the first year of life for all newborns from 1992 to 2000. Discharge diagnoses, hospital days, demographic data and hospital charges for infants born preterm (<36 weeks gestation) were identified and evaluated.Result: About 15% of preterm infants required at least one rehospitalization within the first year of life (average cost per readmission $8468, average annual cost in excess of $41 million). Infants with gestational age <25 weeks had the highest rate of readmission (31%) and longest average length of stay (12 hospital days). The largest cohort, infants born at 35 weeks gestation, had the highest total cost of readmission ($92.9 million). The most common cause of rehospitalization was acute respiratory disease. There was no decrease in the number or cost of readmissions of premature infants for respiratory syncytial virus infections following the introduction of palivizumab in 1998. Conclusion:After initial discharge, premature infants continue to have significant in-patient health-care needs and costs.

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Section: Discussionmentioning

confidence: 99%

Cost, causes and rates of rehospitalization of preterm infants

Danielsen²,

2007

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“…Cost-effectiveness models and analyses of interventions to improve perinatal and neonatal outcomes have been infrequently applied in emerging economies 684 and are rarer still in developing countries. Examples of costeffectiveness assessment of intervention strategies in developing countries have largely included hospitalbased interventions such as routine ultrasonogra- phy, 685 surfactant replacement therapy, 686 prevention of respiratory syncytial virus infections, 687 and (more recently) the successful WHO-modified antenatal care package. 84,688 In other instances, organization of basic neonatal care services in referral hospitals has been shown to be cost-effective.…”

Section: Cost-effectiveness Of Community-based Interventionsmentioning

confidence: 99%

Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence

et al. 2005

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ABSTRACT. Background. Infant and under-5 childhood mortality rates in developing countries have declined significantly in the past 2 to 3 decades. However, 2 critical indicators, maternal and newborn mortality, have hardly changed. World leaders at the United Nations Millennium Summit in September 2000 agreed on a critical goal to reduce deaths of children <5 years by two thirds, but this may be unattainable without halving newborn deaths, which now comprise 40% of all under-5 deaths. Greater emphasis on wide-scale implementation of proven, cost-effective measures is required to save women's and newborns' lives. Approximately 99% of neonatal deaths take place in developing countries, mostly in homes and communities. A comprehensive review of the evidence base for impact of interventions on neonatal health and survival in developingcountry communities has not been reported.Objective. This review of community-based antenatal, intrapartum, and postnatal intervention trials in developing countries aimed to identify (1) key behaviors and interventions for which the weight of evidence is sufficient to recommend their inclusion in communitybased neonatal care programs and (2) key gaps in knowledge and priority areas for future research and program learning.Methods. Available published and unpublished data on the impact of community-based strategies and interventions on perinatal and neonatal health status outcomes were reviewed. Evidence was summarized systematically and categorized into 4 levels of evidence based on study size, location, design, and reported impact, particularly on perinatal or neonatal mortality. The evidence was placed in the context of biological plausibility of the intervention; evidence from relevant developed-country studies; health care program experience in implementation; and recommendations from the World Health Organization and other leading agencies.Results. A paucity of community-based data was found from developing-country studies on health status impact for many interventions currently being considered for inclusion in neonatal health programs. However, review of the evidence and consideration of the broader context of knowledge, experience, and recommendations regarding these interventions enabled us to categorize them according to the strength of the evidence base and confidence regarding their inclusion now in programs. This article identifies a package of priority interventions to include in programs and formulates research priorities for advancing the state of the art in neonatal health care.Conclusions. This review emphasizes some new findings while recommending an integrated approach to safe motherhood and newborn health. The results of this study provide a foundation for policies and programs related to maternal and newborn health and emphasizes the importance of health systems research and evaluation of interventions. The review offers compelling support for using research to identify the most effective measures to save newborn lives. It also may facilitate dialogue with policy...

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“…[1][2][3][4][5] For decades, the agent most frequently linked to these severe episodes has been respiratory syncytial virus (RSV). RSV is responsible for 2% to 18% of severe LRTI cases in VLBW infants year-round.…”

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confidence: 99%