OBJECTIVES: Respiratory syncytial virus (RSV) is a leading cause of hospitalization with severe acute respiratory infections, particularly in the first year of life. Until 2023, palivizumab was the only available intervention to prevent severe RSV disease in a limited infant population at high individual risk. This study aims to quantify the health care resource use and costs associated with palivizumab immunization in Germany.

METHODS: We retrospectively analyzed statutory health insurance claims data of infants born from 2015 to 2019 in Germany. The infant population eligible for palivizumab immunization, consisting of preterm infants with a gestational age less than 29 weeks, congenital heart disease, or bronchopulmonary dysplasia, was identified in the data using ICD-10 codes in the inpatient and outpatient setting. Resource use and costs related to palivizumab immunizations were determined in the data using hospital remuneration numbers and operation and procedure codes for inpatient administrations and ATC codes for outpatient administrations.

RESULTS: Over the study period, 1.4% of infants received at least one dose of palivizumab in the first year of life. Almost all infants who received palivizumab (97.8%) were eligible for immunization. Per infant immunized, irrespective of underlying risk factors, the mean number of doses was 4.6 in the first year of life. Mean cost of palivizumab per infant who received at least one dose in the first year of life was €5,435.

CONCLUSIONS: Our study is the first to estimate RSV immunization rates and associated resource use and costs in Germany. Despite the high risk of severe RSV infections, the overall share of infants that benefit from existing prophylaxis with palivizumab is low. New interventions (such as long-acting monoclonal antibodies) may have the potential to prevent RSV infections in a broader infant population.