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Cost-effectiveness of rule-based immunoprophylaxis against respiratory syncytial virus infections in preterm infants.
- Source :
-
European Journal of Pediatrics . Jan2018, Vol. 177 Issue 1, p133-144. 12p. 2 Diagrams, 3 Charts, 2 Graphs. - Publication Year :
- 2018
-
Abstract
- The objective of the paper is to assess the cost-effectiveness of targeted respiratory syncytial virus (RSV) prophylaxis based on a validated prediction rule with 1-year time horizon in moderately preterm infants compared to no prophylaxis. Data on health care consumption were derived from a randomised clinical trial on wheeze reduction following RSV prophylaxis and a large birth cohort study on risk prediction of RSV hospitalisation. We calculated the incremental cost-effectiveness ratio (ICER) of targeted RSV prophylaxis vs. no prophylaxis per quality-adjusted life year (QALYs) using a societal perspective, including medical and parental costs and effects. Costs and health outcomes were modelled in a decision tree analysis with sensitivity analyses. Targeted RSV prophylaxis in infants with a first-year RSV hospitalisation risk of > 10% resulted in a QALY gain of 0.02 (0.931 vs. 0.929) per patient against additional cost of €472 compared to no prophylaxis (ICER €214,748/QALY). The ICER falls below a threshold of €80,000 per QALY when RSV prophylaxis cost would be lowered from €928 (baseline) to €406 per unit. At a unit cost of €97, RSV prophylaxis would be cost saving.<bold>Conclusions: </bold>Targeted RSV prophylaxis is not cost-effective in reducing RSV burden of disease in moderately preterm infants, but it can become cost-effective if lower priced biosimilar palivizumab or a vaccine would be available. [ABSTRACT FROM AUTHOR]
- Subjects :
- *PREMATURE infant diseases
*TARGETED drug delivery
*RESPIRATORY syncytial virus infections
*PREVENTIVE medicine
*RANDOMIZED controlled trials
*THERAPEUTICS
*PREMATURE infant disease prevention
*ANTIVIRAL agents
*MEDICAL care cost statistics
*COMPARATIVE studies
*COST effectiveness
*DECISION making
*DECISION trees
*PREMATURE infants
*LONGITUDINAL method
*RESEARCH methodology
*MEDICAL cooperation
*RESEARCH
*RESEARCH funding
*EVALUATION research
*TREATMENT effectiveness
*BLIND experiment
*QUALITY-adjusted life years
*DIAGNOSIS
*ECONOMICS
*PREVENTION
Subjects
Details
- Language :
- English
- ISSN :
- 03406199
- Volume :
- 177
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- European Journal of Pediatrics
- Publication Type :
- Academic Journal
- Accession number :
- 127041091
- Full Text :
- https://doi.org/10.1007/s00431-017-3046-1