BACKGROUND:
The objectives were to compare actual respiratory syncytial virus (RSV) hospitalization rates and costs in a cohort of Inuit infants to hypothetical palivizumab prophylaxis strategies for infants of all gestational ages in the Eastern Canadian Arctic.
METHODS:
Incidence and costs of RSV hospitalization were collected for infants admitted to the Baffin Regional Hospital in 2002, before the initiation of palivizumab.
There was a comparison of the actual costs to the costs associated with 8 palivizumab strategies stratified by age (<6 months, <1 year) and location (overall, town [Iqaluit], rural communities). It was assumed that each category would receive universal palivizumab prophylaxis resulting in a 78% decrease in RSV admissions.
The net costs incurred, number needed to treat (NNT), and incremental costs per hospitalization avoided were calculated for each comparison.
RESULTS:
There was a great variation in the rates and costs associated with RSV admissions between Iqaluit and the communities.
For infants <1 year of age residing in Iqaluit, the mean admission cost was $3915, and palivizumab prophylaxis had an NNT of 20.4 and cost of $162,551 per admission avoided.
For rural infants <6 months, the mean cost of admission was $23,030, and palivizumab prophylaxis resulted in an NNT of 3.9 to 2.5 and cost savings of up to $8118 per admission avoided.
CONCLUSIONS:
Due to the high rates and costs associated with RSV admissions, administration of palivizumab in rural communities in the Canadian Arctic to infants less than 6 months of age could result in net cost savings.
2009-08-10
Eng.
The Pediatric infectious disease journal
Department of Pediatrics and Dalla Lana School of Public Health, St. Michael's Hospital, University of Toronto, Toronto, Canada. anna.banerji [at] utoronto.ca
Pediatr Infect Dis J. 2009 Aug;28(8):702-6
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