OBJECTIVES

: Viral respiratory infection (VRI) is the main cause of hospitalization in pediatric patients under 2 years of age. It is estimated that hospital expenses secondary to this disease reach up to $1.4 billion; research on hospitalizations for VRI showed that the main etiologic agent was respiratory syncytial virus (RSV). RSV is a common and highly contagious viral agent, and it is estimated that 95% of children experience at least one infection before two years of age. Extreme prematurity (birth at <29 weeks) is a significant and known risk factor for severe RSV infection. in this study we assess the cost-effectiveness of palivizumab in extreme preterm infants at the IMSS.

METHODS

: A decision tree model was developed employing data published by IMSS in 2019 from its System of Information of Integral Health Care, DataMart and the databases of Family Medicine Units. The comparator was no prophylaxis. The perspective of the study is the IMSS. The costs included in the analysis were the administration of palivizumab, hospital care for RSV infections and the average length of stay in a hospital. The attention costs used was obtained from the annual information published by the IMSS regarding Hospital Products as well the mean hospital stays. The primary efficacy outcome in the palivizumab clinical trials was the number of RSV hospitalizations avoided.

RESULTS

The expected cost was $5,271USD (95% CI, $4,744.40 to $5,798.71) in the palivizumab group and $7,086USD (95% CI, $6,378.14 to $7,795.50) for no prophylaxis. Effectiveness yield to 2.5 (95% CI, 2.39 to 2.64) hospitalization days vs 5.3 (95% CI, 5.07 to 5.60) for the no prophylaxis group (2.8 days less hospitalization days with palivizumab). For the extreme preterm newborns group palivizumab prophylaxis was a dominant Strategy.

CONCLUSIONS

: Palivizumab prophylaxis for extreme preterm newborns (birth at <29 weeks) resulted in a dominant alternative.