Cost-utility analysis of palivizumab for preventing respiratory syncytial virus in preterm neonates and infants in Colombia.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968551 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2334 (Electronic) Linking ISSN: 14712334 NLM ISO Abbreviation: BMC Infect Dis Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Respiratory Syncytial Virus Infections*/drug therapy ; Respiratory Syncytial Virus Infections*/epidemiology ; Respiratory Syncytial Virus Infections*/prevention & control ; Respiratory Syncytial Virus, Human* ; Heart Defects, Congenital*; Infant ; Infant, Newborn ; Humans ; Palivizumab/therapeutic use ; Cost-Benefit Analysis ; Colombia/epidemiology ; Antiviral Agents/therapeutic use ; Infant, Premature ; Antibodies, Monoclonal, Humanized/therapeutic use ; Hospitalization

Aim: Palivizumab has proven effective in reducing hospitalizations, preventing severe illness, improving health outcomes, and reducing healthcare costs for infants at risk of respiratory syncytial virus (RSV) infection. We aim to assess the value of palivizumab in preventing RSV infection in high-risk infants in Colombia, where RSV poses a significant threat, causing severe respiratory illness and hospitalizations.
Methods: We conducted a decision tree analysis to compare five doses of palivizumab with no palivizumab. The study considered three population groups: preterm neonates (≤ 35 weeks gestational age), infants with bronchopulmonary dysplasia (BPD), and infants with hemodynamically significant congenital heart disease (CHD). We obtained clinical efficacy data from IMpact-RSV and Cardiac Synagis trials, while we derived neonatal hospitalization risks from the SENTINEL-1 study. We based hospitalization and recurrent wheezing management costs on Colombian analyses and validated them by experts. We estimated incremental cost-effectiveness ratios and performed 1,000 Monte Carlo simulations for probabilistic sensitivity analyses.
Results: Palivizumab is a dominant strategy for preventing RSV infection in preterm neonates and infants with BPD and CHD. Its high efficacy (78% in preventing RSV in preterm infants), the substantial risk of illness and hospitalization, and the high costs associated with hospitalization, particularly in neonatal intensive care settings, support this finding. The scatter plots and willingness-to-pay curves align with these results.
Conclusion: Palivizumab is a cost-saving strategy in Colombia, effectively preventing RSV infection in preterm neonates and infants with BPD and CHD by reducing hospitalizations and lowering healthcare costs.
(© 2024. The Author(s).)

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Keywords: Bronchopulmonary dysplasia; Congenital heart defects; Palivizumab; Premature birth; Respiratory sounds; Respiratory syncytial viruses

DQ448MW7KS (Palivizumab)
0 (Antiviral Agents)
0 (Antibodies, Monoclonal, Humanized)

Date Created: 20240419 Date Completed: 20240422 Latest Revision: 20240426

20240426

PMC11031882

10.1186/s12879-024-09300-5

38641577