Authors' objectives:

Research question was what is the evidence for the cost and clinical effectiveness of palivizumab prophylaxis versus no prophylaxis against lower respiratory tract disease caused by RSV in pediatric patients who are at high risk for RSV? In particular: 1. premature infants (29 to 32 weeks gestational age and 33 to 35 weeks 2. gestational age)infants with BPD 3. children with hemodynamically significant CHD.

Authors' recommendations: Palivizumab has been shown to reduce RSV associated hospitalization compared with placebo, as determined by one RCT of premature children (<32 weeks gestational age, and 32 to 35 weeks gestational age), some of whom had bronchopulmonary dysplasia. A second RCT demonstrated reductions in RSV-associated hospitalization in children with hemodynamically significant congenital heart disease. These are the only RCTs examining the efficacy of palivizumab in these groups of children. No Canadian economic evaluations of palivizumab were found, although the costs of palivizumab were reported in a Canadian study. A recent review states that the cost-effectiveness of palivizumab is difficult to assess because of the lack of high quality cost-benefit analyses. Societal costs such as the loss of parents wages were not always considered in economic analyses, and therefore, a true determination of cost-effectiveness is challenging. The CPS recommends that palivizumab be considered for children at the highest risk, such as children with BPD, and children born at 32 weeks gestation. Children born between 32 weeks and 35 weeks gestational age may not be at high risk for RSV hospitalization, and considering the costs of palivizumab, these infants should be assessed for other risk factors because palivizumab may be unnecessary. Palivizumab is an expensive option, but it has been shown to be effective for certain groups of infants and children.

Authors' methods: Systematic review, Cost study

Project Status: Completed

URL for project: http://www.cadth.ca/media/pdf/I3006_tr_Palivizumab_e.pdf

Year Published: 2007

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Canadian Agency for Drugs and Technologies in Health

Contact Address: 600-865 Carling Avenue, Ottawa, ON K1S 5S8 Canada. Tel: +1 613 226 2553; Fax: +1 613 226 5392;

Contact Name: requests@cadth.ca

Contact Email: requests@cadth.ca

Copyright: Canadian Agency for Drugs and Technologies in Health (CADTH)