A new cost-utility analysis assessing risk factor-guided prophylaxis with palivizumab for the prevention of severe respiratory syncytial virus infection in Italian infants born at 29-35 weeks' gestational age

Since the last Italian cost-utility assessment of palivizumab in 2009, new data on the burden of respiratory syncytial virus (RSV) and an International Risk Scoring Tool (IRST) have become available. The objective of this study was to provide an up-to-date cost-utility assessment of palivizumab vers...

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Bibliographic Details
Published in:PloS one 2023-08, Vol.18 (8), p.e0289828-e0289828
Main Authors: Keary, Ian P, Ravasio, Roberto, Fullarton, John R, Manzoni, Paolo, Lanari, Marcello, Paes, Bosco A, Carbonell-Estrany, Xavier, Baraldi, Eugenio, Tarride, Jean-Éric, Rodgers-Gray, Barry
Format: Article
Language:English
Subjects:
Age
Algorithms
Antibodies, Monoclonal, Humanized - therapeutic use
Antiviral Agents - therapeutic use
Biology and life sciences
Complications
Cost analysis
Cost-Benefit Analysis
Decision trees
Disease prevention
Economic aspects
Effectiveness
Emergency medical care
Emergency medical services
Evaluation
Gestational Age
Health aspects
Health risks
Hospitalization
Humans
Infant
Infant, Newborn
Infant, Premature
Infants
Infection
Infections
Intensive care
Italy - epidemiology
Medical care, Cost of
Medical research
Medicine and Health Sciences
Medicine, Experimental
Monoclonal antibodies
Morbidity
Multiple births
Palivizumab
Palivizumab - therapeutic use
People and Places
Premature babies
Premature birth
Prevention
Prophylaxis
Reimbursement
Respiratory syncytial virus
Respiratory Syncytial Virus Infections - epidemiology
Respiratory Syncytial Virus, Human
Risk analysis
Risk assessment
Risk Factors
Social Sciences
Statistical analysis
Virus diseases
Viruses
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Summary:Since the last Italian cost-utility assessment of palivizumab in 2009, new data on the burden of respiratory syncytial virus (RSV) and an International Risk Scoring Tool (IRST) have become available. The objective of this study was to provide an up-to-date cost-utility assessment of palivizumab versus no prophylaxis for the prevention of severe RSV infection in otherwise healthy Italian infants born at 29-31 weeks' gestational age (wGA) infants and those 32-35wGA infants categorized as either moderate- or high-risk of RSV-hospitalization (RSVH) by the IRST. A decision tree was constructed in which infants received palivizumab or no prophylaxis and then could experience: i) RSVH; ii) emergency room medically-attended RSV-infection (MARI); or, iii) remain uninfected/non-medically attended. RSVH cases that required intensive care unit admission could die (0.43%). Respiratory morbidity was considered in all surviving infants up to 18 years of age. Hospitalization rates were derived from Italian data combined with efficacy from the IMpact-RSV trial. Palivizumab costs were calculated from vial prices (50mg: €490.37 100mg: €814.34) and Italian birth statistics combined with a growth algorithm. A lifetime horizon and healthcare and societal costs were included. The incremental cost-utility ratio (ICUR) was €14814 per quality-adjusted life year (QALY) gained in the whole population (mean: €15430; probability of ICUR being
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0289828