Anticipated Costs of Hospitalization for Respiratory Syncytial Virus Infection in Young Children at Risk

Rietveld, Edwin; Jonge, H C C de; Polder, J.J.; Vergouwe, Yvonne; Veeze, Henk J.; Moll, Henriëtte A.; Steyerberg, Ewout W.

doi:10.1097/01.inf.0000129690.35341.8d

Cited by 33 publications

(41 citation statements)

References 25 publications

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“…The epidemiology of RSV shows a recurrent seasonal incidence pattern, similar to that of influenza, with an incidence peak in the winter months [3][4][5][6][7]. A previous RSV-infection may provide transient protection but does not prevent subsequent infections later on in life [2,8,9].…”

Section: Introductionmentioning

confidence: 99%

“…Given the disease burden in the first year, vaccination was considered as early as possible. For a three-dose schedule vaccination was considered for infants [5,6] at the ages of 0, 1 and 3 months with vaccine efficacies of 30%, 60% and 75%, respectively. For a two-dose schedule, vaccination was considered at 0 and 3 month of age with vaccine efficacies of 30% and 70%.…”

Section: Vaccine Efficacy and Vaccination Strategiesmentioning

confidence: 99%

“…The course of many RSV-related episodes is mild but in a number of cases it is associated with a lower respiratory tract infection [1]. In approximately 1-2% of the cases, RSV-infection may lead to pneumonia and bronchiolitis requiring hospitalization [1,2,5,6,10]. Risk factors for RSV-hospitalization include prematurity, congenital heart disease (CHD) and bronchopulmonary dysplasia (BPD).…”

Section: Introductionmentioning

confidence: 99%

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Cost-effectiveness of potential infant vaccination against respiratory syncytial virus infection in The Netherlands

Meijboom

Rozenbaum²,

Benedictus

et al. 2012

Vaccine

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Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. t r a c tIntroduction: Respiratory syncytial virus (RSV) infection is one of the major causes of respiratory illness in infants, infecting virtually every child before the age of 2 years. Currently, several Phase 1 trials with RSV vaccines in infants are ongoing or have been completed. As yet, no efficacy estimates are available for these vaccine candidates. Nevertheless, cost-effectiveness estimates might be informative to enable preliminary positioning of an RSV vaccine. Methods: A decision analysis model was developed in which a Dutch birth cohort was followed for 12 months. A number of potential vaccination strategies were reviewed such as vaccination at specific ages, a two-or three-dosing scheme and seasonal vaccination versus year-round vaccination. The impact of the assumptions made was explored in various sensitivity analyses, including probabilistic analysis. Outcome measures included the number of GP visits, hospitalizations and deaths, costs, quality-adjusted life years and incremental cost-effectiveness ratios (ICERs). Results: Currently, without vaccination, an annual number of 28,738 of RSV-related GP visits, 1623 hospitalizations, and 4.5 deaths are estimated in children in the age of 0-1 year. The total annual cost to society of RSV in the non-vaccination scenario is D 7.7 million (95%CI: 1.7-16.7) and the annual disease burden is estimated at 597 QALYs (95%CI: 133-1319). In case all infants would be offered a potentially safe and effective 3-dose RSV vaccination scheme at the age of 0, 1 and 3 months, the total annual net costs were estimated to increase to D 21.2 million, but 544 hospitalizations and 1.5 deaths would be averted. The ICER was estimated at D 34,142 (95%CI: D 21,652-D 87,766) per QALY gained. A reduced dose schedule, seasonal vaccination, and consideration of out-of-pocket expenses all resulted in more favorable ICER values, whereas a reduced vaccine efficacy or a delay in the timing of vaccination resulted in less favorable ICERs. Discussion: Our model used recently updated estimates on the burden of RSV disease in children and it included plausible utilities. However, due to the absence of clinical trial data, a number of crucial assumptions had to be made related to the characteristics of potential RSV vaccine. The outcomes of our modeling exercise show that vaccination of infants against RSV might be cost-effective. However, clinical trial data are warranted.

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Section: Introductionmentioning

confidence: 99%

Section: Vaccine Efficacy and Vaccination Strategiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cost-effectiveness of potential infant vaccination against respiratory syncytial virus infection in The Netherlands

Meijboom

Rozenbaum²,

Benedictus

et al. 2012

Vaccine

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“…Over 85% of all children experiencing RSV hospitalization are born at term or later [33,135]. As shown in Paes et al [151], the model developed in Sampalis et al [146] cannot accurately predict RSV hospitalization or ED visit for term infants.…”

Section: Predicting Rsv Hospitalizationmentioning

confidence: 99%

“…For an individual patient to be admitted for RSV infection, Rietveld et al [135] developed a linear regression model to predict hospitalization cost, with an R 2 of 8% indicating low prediction accuracy. Fieldston et al [136] showed that zip code-based median annual household income is a predictor of hospitalization cost for bronchiolitis patients.…”

Section: Predicting Hospitalization Costmentioning

confidence: 99%

A systematic review of predictive modeling for bronchiolitis

Luo

Nkoy

Gesteland

et al. 2014

International Journal of Medical Informatics

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Purpose: Bronchiolitis is the most common cause of illness leading to hospitalization in young children. At present, many bronchiolitis management decisions are made subjectively, leading to significant practice variation among hospitals and physicians caring for children with bronchiolitis. To standardize care for bronchiolitis, researchers have proposed various models to predict the disease course to help determine a proper management plan. This paper reviews the existing state of the art of predictive modeling for bronchiolitis. Predictive modeling for respiratory syncytial virus (RSV) infection is covered whenever appropriate, as RSV accounts for about 70% of bronchiolitis cases.Methods: A systematic review was conducted through a PubMed search up to April 25, 2014. The literature on predictive modeling for bronchiolitis was retrieved using a comprehensive search query, which was developed through an iterative process.Search results were limited to human subjects, the English language, and children (birth-18 years). Results:The literature search returned 2,312 references in total. After manual review, 168 of these references were determined to be relevant and are discussed in this paper. We identify several limitations and open problems in predictive modeling for bronchiolitis, and provide some preliminary thoughts on how to address them, with the hope to stimulate future research in this domain. Conclusions:Many problems remain open in predictive modeling for bronchiolitis. Future studies will need to address them to achieve optimal predictive models.

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