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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 :
- Complementary Index
- Journal :
- European Journal of Pediatrics
- Publication Type :
- Academic Journal
- Accession number :
- 127041091
- Full Text :
- https://doi.org/10.1007/s00431-017-3046-1