To evaluate the costs and benefits of two new agents, respiratory syncytial virus immune globulin (RSVIG) and palivizumab, to prevent respiratory syncytial virus (RSV) infection among premature infants discharged from the neonatal intensive care unit (NICU) before the start of the RSV season.
Decision analysis was used to compare the projected societal cost-effectiveness of three strategies-RSVIG, palivizumab, and no prophylaxis-among a hypothetical cohort of premature infants.
Probabilities and costs of hospitalization were derived from a cohort of 1721 premature infants discharged from six Kaiser Permanente-Northem California NICUs.
Efficacies of prophylaxis were based on published trials.
Costs of prophylaxis were derived from published sources.
Mortality among infants hospitalized for RSV was assumed to be 1.2%. Future benefits were discounted at 3%. Results.
Palivizumab was both more effective and less costly than RSVIG.
Cost-effectiveness varied widely by subgroup.
Palivizumab appeared most cost-effective for infants whose gestational age was <=32 weeks, who required >=28 days of oxygen in the NICU, and who were discharged from the NICU from September through November.
In this subgroup, palivizumab was predicted to cost $12 000 per hospitalization averted (after taking into account savings from prevention of RSV admissions) or $33 000 per life-year saved, and the number needed to treat to avoid one hospitalization was estimated at 7.4. (...)
Mots-clés Pascal : Virose, Infection, Virus syncytial humain, Spumavirinae, Retroviridae, Virus, Bronchiolite, Palivizumab, Immunoglobuline, Prévention, Analyse coût efficacité, Chimiothérapie, Efficacité traitement, Nourrisson, Homme, Prématuré, Etude comparative, Economie santé, Appareil respiratoire pathologie, Bronche pathologie
Mots-clés Pascal anglais : Viral disease, Infection, Human syncytial virus, Spumavirinae, Retroviridae, Virus, Bronchiolitis, Palivizumab, Immunoglobulins, Prevention, Cost efficiency analysis, Chemotherapy, Treatment efficiency, Infant, Human, Premature, Comparative study, Health economy, Respiratory disease, Bronchus disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0496033
Code Inist : 002B05C02C. Création : 22/03/2000.