Reducing the burden of respiratory syncytial virus: An audit of the use of palivizumab prophylaxis in the UK during the September 2001–March 2002 RSV season

Thwaites, Richard; Edwards, Kathryn M.; Buchan, Scot

doi:10.1016/j.jnn.2007.12.011

Cited by 2 publications

(4 citation statements)

References 20 publications

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“…In this audit, 9.5% of infants received only one dose, 10% two doses, 17.4% three doses, 23.2% four doses, 36.3% five doses and 3.7% six doses. 33 More recent real-world evidence from around the world confirms the UK data. Doses varied across the studies, and were 3.5 doses 34 or 4 doses in Brazil, 35 3.7 doses in Korea 36 and 3.8 doses in Latin America.…”

Section: Number Of Dosesmentioning

confidence: 74%

“…This work differs from earlier work by Wang et al 24,25 and Bentley et al 27 since the base case considers a lower number of doses of palivizumab (3.7 doses versus 5 doses). We believe that this is an appropriate approach for a number of reasons: it reflects real world evidence in the UK 33 and world-wide, [34][35][36][37] advice from UK clinicians supports this approach and the seasonality of the virus means that patients born in season and those in neonatal ICU in season will require fewer doses. 10…”

Section: Strengths and Limitationsmentioning

confidence: 90%

“…However, in this iteration of the model we chose to assume a dose of 3.7 reflecting the seasonality of infection and real-world evidence. 3,10,[33][34][35][36][37] The JCVI guidelines recommend that palivizumab is given from the beginning of the RSV season (October) and that infants in hospital should only receive palivizumab on discharge from the neonatal unit. 3 Recent consensus guidelines 10 state that children born during the RSV season will require fewer doses than those born before the season, which is confirmed by work we carried out around the seasonality of RSV for this publication.…”

Section: Number Of Dosesmentioning

confidence: 99%

“…Similar data from the US considered RSV hospitalizations in premature infants before and after the 2014 American Academy of Pediatrics (AAP) guidance on the use of prophylaxis which recommended against the use of palivizumab in infants born at 29-34 wGA unless the infant had an underlying health condition, including BPD or CHD. 48 The study compared the rate ratios for RSV hospitalization in premature (29)(30)(31)(32)(33)(34) and full term (>36 wGA) infants. During the period in which palivizumab was recommended, the rate ratio (rate of hospitalization for RSV in premature infants compared to rate of hospitalization for RSV in term infants aged <6 months, rate ratio >1 indicates higher rates of RSV hospitalization in the premature cohort) ranged from 1.6 to 3.4 depending on the setting (commercial, Medicaid, age <3 months, age 3-6 months).…”

Section: Cost Effective Populations For Palivizumabmentioning

confidence: 99%

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Updated cost-effectiveness analysis of palivizumab (Synagis) for the prophylaxis of respiratory syncytial virus in infant populations in the UK

Narayan

Bentley

Mowbray

et al. 2020

Journal of Medical Economics

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Aims: Respiratory syncytial virus (RSV) is a common cause of respiratory infection in infants and severe infection can result in hospitalization. The passive immunization, palivizumab, is used as prophylaxis against RSV, however, use in the UK is restricted to populations at high risk of hospitalization. This study assesses the cost-effectiveness (CE) of palivizumab in premature infants with and without risk factors for hospitalization (congenital heart disease [CHD], bronchopulmonary dysplasia [BPD]). Methods: A decision tree model, based on earlier CE analyses, was updated using data derived from targeted literature reviews and advice gained from a Round Table meeting. All costs were updated to 2019 prices. One-way and probabilistic sensitivity analyses were performed to assess the degree of uncertainty surrounding the results. Results: Palivizumab is dominant (i.e. clinically superior and cost saving) when used in premature infants born 35 weeks gestational age (wGA) without CHD or BPD and aged <6 months at the start of the RSV season, infants aged <24 months with CHD and infants aged <24 months requiring treatment for BPD within the last 6 months. Limitations: One-way sensitivity analysis suggests that these results are highly sensitive to the efficacy of prophylaxis, number of doses, impact of long-term respiratory sequalae, rate of hospitalization and mortality due to RSV. A conservative approach has been taken toward long-term respiratory sequalae due to uncertainty around epidemiology and etiology and a lack of recent cost and utility data. Conclusions: Palivizumab prophylaxis is cost-effective in preventing severe RSV infection requiring hospital admission in a wider population than currently recommended in UK guidelines. Prophylaxis in premature infants born <29 wGA, 29-32 wGA and 33-35 wGA without CHD or BPD aged <6 months at the start of the RSV season is not funded under current guidance, however, prophylaxis has been demonstrated to be cost-effective in this analysis.

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Section: Number Of Dosesmentioning

confidence: 74%

Section: Strengths and Limitationsmentioning

confidence: 90%

Section: Number Of Dosesmentioning

confidence: 99%

Section: Cost Effective Populations For Palivizumabmentioning

confidence: 99%

See 2 more Smart Citations

Updated cost-effectiveness analysis of palivizumab (Synagis) for the prophylaxis of respiratory syncytial virus in infant populations in the UK

Narayan

Bentley

Mowbray

et al. 2020

Journal of Medical Economics

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Adherence and outcomes: a systematic review of palivizumab utilization

Wong

Lanctôt

et al. 2017

Expert Review of Respiratory Medicine

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Palivizumab is a humanized monoclonal antibody used for respiratory syncytial virus (RSV) prophylaxis. RSV is the primary cause of lower respiratory tract infection in children aged <2 years, and can give rise to high-burden hospitalization and respiratory complications in later life. Adherence to a monthly dosing regimen, both in timing and injection number, is essential to sustain therapeutic levels of palivizumab and maintain protective status. Deviation from the approved dosing schedule may reduce the efficacy of palivizumab and increase the risk of breakthrough RSV infection and hospitalization. Areas covered: There is no standardized definition of adherence to palivizumab treatment. This review addresses the wide variability in defining and reporting adherence to palivizumab prophylaxis across different studies. The review assesses whether a relationship exists in the outcomes reported in studies relative to the monthly adherence protocol as defined in published randomized controlled trials of the efficacy and safety of palivizumab. Expert commentary: Standardized detailed reporting of adherence to palivizumab prophylaxis using consistent definitions will help provide a more robust level of evidence. This information may be important when considering variations in effectiveness, alterations to recommendations and guidelines, and cost-effectiveness of treatment.

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Reducing the burden of respiratory syncytial virus: An audit of the use of palivizumab prophylaxis in the UK during the September 2001–March 2002 RSV season

Cited by 2 publications

References 20 publications

Updated cost-effectiveness analysis of palivizumab (Synagis) for the prophylaxis of respiratory syncytial virus in infant populations in the UK

Updated cost-effectiveness analysis of palivizumab (Synagis) for the prophylaxis of respiratory syncytial virus in infant populations in the UK

Adherence and outcomes: a systematic review of palivizumab utilization

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