Palivizumab for immunoprophylaxis of respiratory syncitial virus (RSV) bronchiolitis in high-risk infants and young children: a systematic review and additional economic modelling of subgroup analyses

Abstract

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Acute viral bronchiolitis in South Africa: Strategies for management and prevention

“…At the current cost of palivizumab, it is extre mely expensive to recommend its widespread use; it is therefore restricted to high-risk groups. [24] For the prevention of RSV-associated bronchiolitis, the South African (SA) guide line for the use of palivizumab recommends that it should be restricted for use in the first 6 months of life in highrisk children, defined as premature infants. [21,22] Furthermore, infants with chronic lung disease of prematurity or those with congenital heart defects with signi ficant haemodynamic instability (complex lesions with pulmonary hypertension) and the premature neonate who is a graduate of an ICU and has ongoing respiratory or cardiac compromise (diuretic, oxygen or corticosteroid dependent), should be covered during the first 24 months of life and during the RSV season.…”

Ameliorating Effect of Dietary Xylitol on Human Respiratory Syncytial Virus (hRSV) Infection

“…Synagis, a humanized monoclonal antibody that targets hRSV F protein has been indicated for preventing hRSV infection in infants who are considered at high risk of hRSV disease. 7) Synagis did not have any clinical benefit in children already afflicted with hRSV although it is highly effective as a prophylactic against hRSV. Ribavirin, a guanosine analog that exhibits antiviral activity against RNA and DNA viruses, is the only agent approved for treating hRSV infection.…”

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.…”