Article Text

PDF

Infections: from vaccination to treatments
P170 A cost-effectiveness analysis of respiratory syncytial virus (RSV) prophylaxis in infants in the UK
  1. A Bentley1,
  2. I Filipovic2,
  3. K Gooch2,
  4. K Buesch2
  1. 1Abacus International, Bicester, UK
  2. 2Abbott Laboratories, Solna, Sweden

Abstract

Background and Aim RSV is the most common cause of lower respiratory tract infection in young children and may result in hospitalisations, long-term sequelae, such as recurrent wheeze and/or asthma, and possibly death. Palivizumab is a prophylaxis against severe RSV infection and has been shown to reduce RSV-related hospitalisations, and provides a preventative option for high-risk infants. The aim of this study is to demonstrate the cost-effectiveness of RSV prophylaxis compared to no prophylaxis in the following high-risk infants groups: infants with chronic lung disease (CLD) and premature babies (<29, 29–32 and 33–35 weeks gestational age (wGA)).

Methods A decision-tree model was developed to reflect the clinical pathway of infants at high-risk of severe RSV infection. Baseline risk of RSV-hospitalisations and efficacy data were taken from palivizumab clinical trials and published meta-analysis. Cost data were obtained from national databases and published literature using an NHS perspective. The main outcome was presented as the incremental costs per Quality-Adjusted Life-Year (QALY) gained (ICER). The base-case analysis considered a lifetime horizon to capture the impact of long-term morbidity and mortality associated with RSV hospitalisations.

Results Prophylaxis against severe RSV infection resulted in ICERs of £19 168, £18 174 & £1185 per QALY for high-risk infants with, CLD and the premature infant groups, <29 wGA and 29–32 wGA respectively compared to no prophylaxis. All results are below the accepted NICE threshold of £30 000 /QALY thus demonstrating cost-effectiveness. The baseline ICER for the 33–35 wGA subgroup was above this threshold however, sensitivity analysis considering risk-factors in this subgroup showed that an increase in baseline risk of hospitalisation, from 7.2% to 11.24%, led to palivizumab becoming a cost-effective option.

Conclusions Severe RSV infection in high-risk infants represents a significant cause of morbidity and mortality and is associated with a high economic burden. Palivizumab was found to be cost-effective compared to no prophylaxis in the UK in all of the subgroups considered, demonstrating a good use of NHS resources.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.