Cost utility of palivizumab prophylaxis among pre-term infants in the United States: a national policy perspective

Abstract

From a national policy perspective, palivizumab remained cost-effective for publically and commercially insured, guideline-eligible, high-risk premature infants. Palivizumab was not cost-effective in infants of 32-35 wGA with ≤ 1 RF.

Discovery of Imidazopyridine Derivatives as Highly Potent Respiratory Syncytial Virus Fusion Inhibitors

“…2,3 In adults and the elderly, RSV pneumonia is increasingly recognized as a significant cause of morbidity and mortality, being associated with more than 17,000 deaths annually between 1991 and 1998. 4−6 Although the research into the prevention and treatment of RSV infection has been ongoing for almost 40 years, vaccine development is difficult, 7,8 and to date, there is no clinically approved vaccine. Passive immunization with the monoclonal antibody Palivizumab (Synagiss) has provided about 50% protection to high-risk children.…”

Cross-resistance mechanism of respiratory syncytial virus against structurally diverse entry inhibitors

“…RSV disease is the leading cause of virus infection-induced death among children less than 1 year of age (1) and can be life-threatening to the elderly and the immunocompromised (2,3). Reinfection with RSV can occur throughout life (4), but infants born prematurely, or with bronchopulmonary dysplasia or a congenital heart defect, are at highest risk of developing severe disease (5). In a typical case, initial RSV infection of airway epithelia cells is followed by rapid spread from the nasopharynx to the lower airways that can affect respiratory function through excessive mucus, necrotic epithelial debris, and inflammatory cells obstructing the airways (6,7).…”

“…Although ribavirin was approved for RSV treatment, clinical use is minimal because of efficacy and toxicity issues (8,9). The humanized neutralizing antibody palivizumab is used for immunoprophylaxis of high-risk pediatric patients, but high costs prohibit broad-scale implementation (5,(10)(11)(12)(13).…”

RSV Immunoprophylaxis: Does the Benefit Justify the Cost?

“…13,14 Cost-analyses sponsored by the manufacturer generally show cost neutrality or even cost saving. 15,16 Among independently conducted cost analyses, the cost of prophylaxis with palivizumab is generally found to far exceed the economic benefit of hospital avoidance, even among infants at highest risk. 9,[17][18][19][20] For the highest-risk infants (those born at 23-32 weeks' gestation and who required at least 28 days of supplemental oxygen in the NICU), the number needed to treat to prevent 1 hospitalization in the IMpact-RSV trial was 8.5.…”