Protecting High-Risk Preterm Infants With Synagis(R) Is Affordable

Main Category: Respiratory / Asthma
Also Included In: Pediatrics / Children's Health
Article Date: 25 Aug 2009 - 1:00 PST

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A new analysis suggests that expanding prophylaxis with Synagis® (palivizumab), a monoclonal antibody that prevents severe lung disease from respiratory syncytial virus (RSV) in high-risk infants, will help protect more vulnerable premature babies with little increase in health insurance costs.

Additional factors that the research suggests should be considered to determine preventive dosing for preterm infants at high risk for serious RSV disease include exposure to second hand smoke, residential crowding, or being young in age during the RSV season which runs from November through April.

"Infants that are premature and born between 32 and 35 weeks gestation comprise <0.08% in a typical plan with 1 million members. The number of infants is quite small if you look at the population level," said Leonard R. Krilov, MD, lead author, and pediatric infectious disease specialist at Winthrop University Hospital in Mineola, New York. "Infants that have exposure to second hand smoke, live in crowded homes, or are young in age are at high risk of developing severe lower lung infection and may benefit from palivizumab."

According to the study, expanding the recommendations to include these high-risk infants increases the percent of infants 32-35 weeks gestation qualifying for prevention from the current 20% to 55%. Due to the small overall number of infants, this translates to <0.1% increase in child health insurance costs or less than $0.10 per covered life.

Dr. Debra Palazzi from Baylor College of Medicine in Houston, Texas and a co-author on the study added, "The American Academy of Pediatrics guidelines cite costs as a concern since economic analyses do not show net cost savings. Looking across other disease areas, we found we are spending less on Synagis® for high-risk preemies than for treatment of chronic conditions and many other adult health disorders."

"Palivizumab, a monoclonal antibody, is a complex protein and not a vaccine. Despite the high cost of manufacturing and distributing these complex proteins, MedImmune is committed to pediatrics and reinvests heavily in research. MedImmune also funds a patient assistance program, allowing eligible infants who need palivizumab, but without medical insurance, to apply for it at no cost," reports Parthiv Mahadevia, MD, MPH, senior director of health economics at MedImmune.

The full manuscript of this MedImmune-funded study will be published in the January 2010 issue of Value in Health and is available online at http://www.ispor.org/valueinhealth_index.asp.

Value in Health (ISSN 1098-3015) publishes papers, concepts, and ideas that advance the field of pharmacoeconomics and outcomes research and help health care leaders to make decisions that are solidly evidence-based. The journal is published bi-monthly and has a regular readership of over 4,000 clinicians, decision-makers, and researchers worldwide.

ISPOR is a nonprofit, international organization that strives to translate pharmacoeconomics and outcomes research into practice to ensure that society allocates scarce health care resources wisely, fairly, and efficiently.

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ISPOR