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Cost-Effectiveness Analysis of Palivizumab as RSV-Prophylaxis in Preterm Infants in Sweden.
MedLine Citation:
PMID:  21477089     Owner:  NLM     Status:  Publisher    
Aim  To investigate the cost-effectiveness of palivizumab vs. no prophylaxis for RSV infection in preterm infants in Sweden. Methods  A probabilistic Markov model was populated using a nationwide register linkage and data from the literature. Cost-effectiveness was investigated from a societal perspective over a lifetime for infants born at <29 weeks of gestation. Palivizumab was modelled using assumptions for its direct effect on RSV-hospitalization risk, and an indirect effect (via decreased RSV-hospitalization) on subsequent asthma and mortality during the epidemic. Costs and effects were discounted by 3%. Results  In the base case, prophylaxis resulted in an additional 0.102 QALYs at a cost of 20,000SEK relative to no prophylaxis (incremental cost-effectiveness ratio [ICER] 195,000SEK/QALY). The probability of prophylaxis being cost-effective was 99% at a willingness-to-pay of 500,000SEK/QALY. Assumptions about a causal association between RSV infection and subsequent asthma had a moderate impact, while exclusion of the indirect prophylaxis effect on mortality increased the ICER to 492,000SEK/QALY. When excluding both of these, prophylaxis was not cost-effective. Conclusion:  Based on a willingness-to-pay of 500,000SEK/QALY, palivizumab was found to be cost-effective compared to no prophylaxis for infants born at <29 weeks if severe RSV infection was assumed to increase subsequent asthma or mortality risk.
K Neovius; K Buesch; K Sandström; M Neovius
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-7
Journal Detail:
Title:  Acta paediatrica (Oslo, Norway : 1992)     Volume:  -     ISSN:  1651-2227     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9205968     Medline TA:  Acta Paediatr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Acta Paediatrica © 2011 Foundation Acta Paediatrica.
Snowbox Research AB, Stockholm, Sweden Abbott GmbH & Co. KG, Global Health Economics and Outcomes Research, Knollstrasse 50, Ludwigshafen, Germany Abbott Scandinavia, Stockholm, Sweden Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
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