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The cost effectiveness of palivizumab in term Inuit infants in the Eastern Canadian Arctic.
- Source :
-
Journal of medical economics [J Med Econ] 2009; Vol. 12 (4), pp. 361-70. - Publication Year :
- 2009
-
Abstract
- Introduction: Canadian, Inuit, full term infants have the highest rate of respiratory syncytial virus (RSV) infection globally, which results in substantial costs associated hospitalisation.<br />Methods: Decision-analytical techniques were used to estimate the incremental cost-effectiveness ratio (ICER) for palivizumab compared to no prophylaxis for Inuit infants of all gestational age. The time horizon was that of life-time follow-up, and costs and effectiveness were discounted at 5% per year. Costs (2007 CAD$) for palivizumab, hospitalisation (including medical evacuation, intensive care unit [ICU]), physician visits, and transportation were calculated based on the Canadian payer's perspective. Benefits on decreasing RSV hospitalisation were expressed as quality-adjusted life-years (QALYs). One-way and probabilistic sensitivity analysis (PSA) were conducted, varying: mortality rates, utilities, length of stay in hospital and ICU.<br />Results: For all of Baffin Island infants (<1 year), the ICER was $39,435/QALY. However, when infants were grouped by age and area of residence, those residing in Iqaluit (<1 year) had an ICER of $152,145/QALY, while those residing in rural areas (outside of Iqaluit) had an ICER of $24,750/QALY. Prophylaxis was a dominant strategy (cost saving) for rural infants under 6 months of age, with the PSA demonstrating that it was dominant 98% of the time.<br />Conclusions: The ICERs suggested that palivizumab is a cost-effective option for the prevention of RSV for Inuit infants on Baffin Island compared to no prophylaxis. Palivizumab is highly cost effective in Arctic infants <1 year of age specifically residing outside of Iqaluit and is a dominant strategy for those under 6 months of age in rural areas. However, palivizumab is not cost effective compared to no treatment for infants of all ages residing in Iqaluit.
- Subjects :
- Antibodies, Monoclonal, Humanized
Canada epidemiology
Cost-Benefit Analysis
Decision Support Techniques
Female
Humans
Infant
Male
Nunavut epidemiology
Palivizumab
Quality-Adjusted Life Years
Respiratory Syncytial Virus Infections ethnology
Respiratory Syncytial Virus Infections prevention & control
Antibodies, Monoclonal administration & dosage
Antibodies, Monoclonal economics
Antiviral Agents administration & dosage
Antiviral Agents economics
Inuit statistics & numerical data
Respiratory Syncytial Virus Infections drug therapy
Respiratory Syncytial Virus Infections economics
Subjects
Details
- Language :
- English
- ISSN :
- 1941-837X
- Volume :
- 12
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of medical economics
- Publication Type :
- Academic Journal
- Accession number :
- 19900071
- Full Text :
- https://doi.org/10.3111/13696990903442155