RT Journal Article
T1 Cost-utility analysis of Palivizumab for Respiratory Syncytial Virus infection prophylaxis in preterm infants: update based on the clinical evidence in Spain
A1 Sánchez Luna, Manuel Ramón
A1 Burgos Pol, R.
A1 Oyagüez, I.
A1 Figueras Aloy, J.
A1 Sánchez Solís, M.
A1 Martinón Torres, F.
A1 Carbonell Estrany, X.
AB Background: This study aimed at estimating the efficiency of palivizumab in the prevention of Respiratory SyncytialVirus (RSV) infection and its sequelae in preterm infants (32day 1-35day 0weeks of gestational age –wGA-) in Spain.Methods: A decision-tree model was developed to compare health benefits (Quality Adjusted Life Years-QALYs)and costs of palivizumab versus a non-prophylaxis strategy over 6 years. A hypothetical cohort of 1,000 preterm infants,32day 1-35day 0 wGA (4.356 kg average weight) at the beginning of the prophylaxis (15 mg/kg of palivizumab; 3.88 averagenumber of injections per RSV season) was analysed.The model considered the most recent evidence from Spanish observational and epidemiological studies on RSV infection:the FLIP II study provided hospital admission and Intensive Care Unit (ICU) admission rates; in-hospital mortality rate wasdrawn from an epidemiological study from 2004 to 2012; recurrent wheezing rates associated to RSV infection fromSPRING study were adjusted by the evidence on the palivizumab effect from clinical trials. Quality of life baseline value,number of hospitalized infants and the presence of recurrent wheezing over time were granted to estimate QALYs.National Health Service and societal perspective (included also recurrent wheezing indirect cost) were analysed. Total costs(€, 2016) included pharmaceutical and administration costs, hospitalization costs and recurrent wheezing managementannual costs. A discount rate of 3.0% was applied annually for both costs and health outcomes.Results: Over 6 years, the base case analysis showed that palivizumab was associated to an increase of 0.0731 QALYs compared to non-prophylaxis. Total costs were estimated in €2,110.71 (palivizumab) and €671.68(non-prophylaxis) from the National Health System (NHS) perspective, resulting in an incremental cost utilityratio (ICUR) of €19,697.69/QALYs gained (prophylaxis vs non-prophylaxis). Results derived from the risk-factorspopulation subgroups analysed were in line with the total population results. From the societal perspective,the incremental cost associated to palivizumab decreased to an €1,253.14 (ICUR = €17,153.16€/QALYs gainedfor palivizumab vs non-prophylaxis). One-way and probabilistic sensitivity analyses confirmed the robustness ofthe model.Conclusions: The prophylaxis with palivizumab is efficient for preventing from RSV infections in preterminfants 32day 1-35day 0 wGA in Spain
PB BMC
SN 1471-2334
YR 2017
FD 2017-10-17
LK https://hdl.handle.net/20.500.14352/99436
UL https://hdl.handle.net/20.500.14352/99436
LA eng
NO Sanchez-Luna M, Burgos-Pol R, Oyagüez I, Figueras-Aloy J, Sánchez-Solís M, Martinón-Torres F, Carbonell-Estrany X. Cost-utility analysis of Palivizumab for Respiratory Syncytial Virus infection prophylaxis in preterm infants: update based on the clinical evidence in Spain. BMC Infect Dis. 2017 Oct 17;17(1):687. doi: 10.1186/s12879-017-2803-0. PMID: 29041909; PMCID: PMC5645982.
DS Docta Complutense
RD 24 ago 2024