Is immunoprophylaxis against RSV infections cost effective?

According to an evaluation of the cost effectiveness of immunoprophylaxis with palivizumab against respiratory syncytial virus (RSV) infection, based on actual cost and observed RSV incidence rates in various pediatric risk groups during the 2004 to 2005 RSV infection season in Florida, the answer is no. These groups included children with various combinations of risk factors for RSV-chronic lung disease, congenital heart disease, or prematurity-and children with none of these risk factors. About 159,790 Medicaid-eligible children up to 2 years old were included in the study group.

The analysis showed that the cost of preventing RSV-related hospitalizations with palivizumab far exceeded the savings associated with prevented hospitalizations. Even for the most cost-effective subgroup in the study (premature infants <6 months old), a mean of $302,103 would have to be expended to prevent 1 hospitalization (mean cost, $8,910). Younger age and multiple indications for prophylaxis were associated with improvements in the incremental cost-effectiveness ratio (Hampp C, et al. Arch Pediatr Adolesc Med. 2011;165[6]:498-505).

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