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[Potential impact and cost-efficacy of bronchiolitis prophylaxis with palivizumab in preterm infants with a gestational age of less than 33 weeks].

AbstractINTRODUCTION:
Respiratory syncytial virus (RSV) is the main cause of bronchiolitis in children aged less than 2 years. The effectiveness of palivizumab has recently been reported in several clinical trials.
OBJECTIVE:
The aim of this study was to evaluate the hypothetical impact of a treatment strategy using palivizumab for the prevention of bronchiolitis in premature infants.
METHODS:
Neonates born in our hospital between January 1995 and December 1998 who were admitted for bronchiolitis were included. Using information from the Impact-RSV study, the effects and impact of different cut-off points in the gestational age of the study group were measured. Cost-effectiveness analysis included the cost of hospitalization as well as the direct cost of palivizumab prescriptions.
RESULTS:
Of 7,766 newborn infants, 56 had a gestational age of < or =32 weeks. Of these, bronchiolitis was diagnosed in eight infants (14.28%), and RSV was isolated in seven (14.28%). After hypothetical prophylaxis in premature infants the best results were obtained in the group with a gestational age of 30 weeks. In this group the relative risk of admission for bronchiolitis was 12.1 (95% CI: 4.8-30.5) and treatment would be required in nine infants to avoid one admission (cost Euros 12,915), with a cost 3.8 times greater than the current cost, without prophylaxis.
CONCLUSIONS:
Measurement of the impact and cost-effectiveness analysis of palivizumab prophylaxis provides a useful method for determining recommendations for the prevention of bronchiolitis in premature infants.
AuthorsS Lapeña López de Armentia, Ma B Robles García, J P Martínez Badás, L Castañón Fernández, J Mallo Castaño, B Herrero Mendoza, E Alvaro Iglesias
JournalAnales de pediatria (Barcelona, Spain : 2003) (An Pediatr (Barc)) Vol. 59 Issue 4 Pg. 328-33 (Oct 2003) ISSN: 1695-4033 [Print] Spain
Vernacular TitleImpacto potencial y análisis coste-eficacia de la profilaxis con palivizumab, en la prevención de bronquiolitis, en prematuros menores de 33 semanas de gestación.
PMID14519303 (Publication Type: English Abstract, Journal Article)
Chemical References
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antiviral Agents
  • Palivizumab
Topics
  • Acute Disease
  • Antibodies, Monoclonal (economics, therapeutic use)
  • Antibodies, Monoclonal, Humanized
  • Antiviral Agents (economics, therapeutic use)
  • Bronchiolitis (prevention & control)
  • Cost-Benefit Analysis
  • Gestational Age
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature, Diseases (prevention & control)
  • Palivizumab
  • Retrospective Studies

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