Document Detail


Cost-effectiveness of palivizumab in New Zealand.
MedLine Citation:
PMID:  12173995     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To establish the preterm infant hospitalization risks from respiratory syncytial virus (RSV) in New Zealand and the net cost per hospitalization averted by palivizumab. METHODS: The 437 infants born < 32 weeks' gestation in 1997 and treated at five major neonatal units were identified. Subsequent admissions during the next 2 years for bronchiolitis, pneumonia and croup were tracked, and information collected on RSV tests performed. Data on the length of stay and hospital costs were used to calculate the potential net cost per hospitalization averted associated with the use of palivizumab and the number needed to treat (NNT) to prevent one hospitalization. RESULTS: Estimated RSV readmission risk before 1 year corrected age in infants < 32 weeks' gestation discharged home on oxygen, and those " 28 weeks' gestation, or between 29 and 31 weeks' gestation with or without chronic lung disease was 42%, 23%, 19%, 10% and 8%, respectively. The NNT with palivizumab to prevent one hospitalization ranged from six to 26 across subgroups. Mean (range) net cost per hospitalization averted was 60,000 New Zealand dollars ($28,000-$166,700). In no subgroup would prophylaxis result in net cost saving. Prophylaxis for all NZ infants " 28 weeks' gestation would cost approximately $1,090,000 net and prevent 29 hospitalizations annually, being equivalent to $37,000 net per hospitalization averted, with eight infants treated to prevent one hospitalization. Alternative assumptions about cost and efficacy failed to alter these findings. CONCLUSION: If value is placed on preventing morbidity, the priority groups for palivizumab prophylaxis are preterm infants discharged home on oxygen, followed by preterm infants of 28 weeks' gestation or less.
Authors:
A M Vogel; M J McKinlay; T Ashton; D R Lennon; J E Harding; R Pinnock; D Graham; K Grimwood; P K Pattemore; M Schousboe
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of paediatrics and child health     Volume:  38     ISSN:  1034-4810     ISO Abbreviation:  J Paediatr Child Health     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-08-13     Completed Date:  2002-10-16     Revised Date:  2007-09-24    
Medline Journal Info:
Nlm Unique ID:  9005421     Medline TA:  J Paediatr Child Health     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  352-7     Citation Subset:  IM    
Affiliation:
Department of Paediatrics, University of Auckland, New Zealand. a.vogel@auckland.ac.nz
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MeSH Terms
Descriptor/Qualifier:
Antibodies, Monoclonal / economics*,  therapeutic use
Antiviral Agents / economics*,  therapeutic use
Cost-Benefit Analysis
Hospital Costs*
Humans
Infant, Newborn
Infant, Premature*
Intensive Care Units, Neonatal / economics*
Models, Econometric
New Zealand / epidemiology
Patient Readmission / economics
Respiratory Syncytial Virus Infections / epidemiology,  prevention & control*
Risk
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Antiviral Agents; 0/palivizumab

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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