Respiratory syncytial virus (RSV), the leading cause of lower respiratory tract infection in children, results in an estimated 90,000 hospitalizations and 4,500 deaths each year in the United States. Children with underlying bronchopulmonary dysplasia, prematurity or immunodeficiency are known to be at high-risk for severe RSV illness. OBJECTIVE: To evaluate research addressing the pharmacoeconomics of RSV immunoglobulin (RSV-IG) and palivizumab, the only two available agents, to prevent RSV infection among high-risk infants. METHODS: Studies in English were identified from Medline (1993 to 2000) using search terms like RSV-IG, palivizumab, costs, cost-effectiveness. Additional studies were collected by searching bibliographies of identified articles and contacting study authors and other experts. Data was abstracted from each study using a standardized reporting form. RESULTS: Cost per hospitalization averted was the primary outcome measure across most studies. Cost-effectiveness estimates of RSV-IG have ranged from $3,800 to $8,800 per respiratory related hospitalization prevented, to $24,000 per year of life saved, to $102,608 to prevent hospitalization of a 3.3 kg infant. Economic evaluation of palivizumab also indicate varied estimates ranging from expected savings of