Wall Street Journal Examines Debate Over Use Of Costly Medication For Children

Main Category: Pediatrics / Children's Health
Also Included In: Respiratory / Asthma;  Immune System / Vaccines;  Public Health
Article Date: 18 Apr 2008 - 9:00 PST

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The Wall Street Journal on Wednesday examined how "pediatric experts are wrestling with an emotionally fraught issue: whether to let some babies at risk for a potentially serious respiratory virus take their chances with the disease or to preventively administer an expensive drug that may or may not work." Palivizumab, a synthetic antibody marketed by MedImmune under the brand name Synagis, costs as much as $6,000 for five treatments as a therapy for respiratory syncytial virus, which is the leading cause of hospitalizations for infants and children and infects almost all children at least one time before age two.

According to the Journal, RSV annually accounts for almost 1.7 million physician visits, 400,000 emergency department visits, 125,000 infant hospitalizations and about 500 deaths. Synagis currently is "given to at-risk children in monthly intramuscular injections during RSV season," and, although MedImmune seeks to expand use of the medication, such a move is "hard to justify" based on cost-effectiveness, the Journal reports.

Studies have found that Synagis reduces hospitalizations for RSV by 50%, but the medication does not decrease the number of deaths from the disease. In addition, whether prevention of RSV has any long-term benefits remains undetermined. Health insurers in most cases cover RSV only for use in premature infants in certain age and risk categories established in guidelines from the American Academy of Pediatrics. AAP, which in 2003 made the guidelines more restrictive, plans to revise the guidelines this year (Landro, Wall Street Journal, 4/16).

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