Abstract:
BACKGROUND:Prophylactic therapy with palivizumab, a humanized monoclonal antibody, has been shown to reduce the number of respiratory syncytial virus (RSV)-related hospitalizations in preterm infants. The cost-effectiveness of this therapy has not been evaluated from the provider's perspective using cost data. OBJECTIVES:The objectives of this study were to determine the cost per RSV infection episode avoided by using prophylactic palivizumab therapy in a high-risk infant population and to determine whether certain subgroups of infants derived greater benefit from prophylactic therapy. METHODS:A decision-analytic model simulating an RSV infection episode was developed to evaluate the cost-effectiveness of palivizumab prophylaxis from the perspective of the health care system (provider). Data to populate the model were gathered from the medical literature (identified through a MEDLINE search of studies on the incidence of RSV infection) and the IMpact-RSV clinical trial. Data included incidence of RSV infection and the associated health care resource use and costs. Costs to the provider were determined using a university-affiliated hospital cost-accounting system. Cost-effectiveness ratios were calculated over a range of RSV infection incidence rates in a control population. Sensitivity analyses were performed for the cost of palivizumab therapy, the cost of RSV-related hospitalization, and the number of emergency department, physician office, and home health care visits. For the subgroup analysis, infants were classified by gestational age (<32 and > or = 32 weeks) and stratified by severity of chronic lung disease. RESULTS:The cost per additional RSV infection episode avoided ranged from dollars 0 (cost savings) to dollars 39,591 for palivizumab prophylaxis costs of dollars 2500 and from dollars 2702 to dollars 79,706 for palivizumab prophylaxis costs of dollars 4500. The model was insensitive to changes in the number of emergency department, physician office, and home health care visits. The difference in RSV incidence between the treatment and control groups was greater among infants > or = 32 weeks' gestational age than among infants <32 weeks' gestational age. onclusions: The incremental cost-effectiveness of palivizumab compared with no prophylactic therapy was sensitive to changes in the incidence of RSV infection in control infants, the average cost of RSV hospitalization, and the cost of palivizumab. Clinicians may use this information along with additional factors to determine whether palivizumab is cost-effective in their clinical setting and geographic area.
journal_name
Clin Therjournal_title
Clinical therapeuticsauthors
Lofland JH,O'Connor JP,Chatterton ML,Moxey ED,Paddock LE,Nash DB,Desai SAdoi
10.1016/s0149-2918(00)83032-5subject
Has Abstractpub_date
2000-11-01 00:00:00pages
1357-69issue
11eissn
0149-2918issn
1879-114Xpii
S0149291800830325journal_volume
22pub_type
杂志文章abstract:BACKGROUND:Valproic acid has been associated with a highly variable intersubject absorptive phase; therefore, magnesium salt (magnesium valproate [MgV]) was developed to diminish variation during enteric absorption. OBJECTIVES:The aims of this study were to assess the pharmacokinetics of single oral doses of MgV 500-m...
journal_title:Clinical therapeutics
pub_type: 杂志文章,随机对照试验
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abstract::The total cost of administering calcium polycarbophil per unit dose (two tablets) was compared with that of administering psyllium mucilloid (one packet dissolved in 8 oz of water) in 20 elderly nursing-home residents. Times for printing labels, checking and initialing labels, gathering materials needed, and preparing...
journal_title:Clinical therapeutics
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doi:
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pub_type: 杂志文章,评审
doi:10.1016/S0149-2918(00)88316-2
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journal_title:Clinical therapeutics
pub_type: 杂志文章,评审
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journal_title:Clinical therapeutics
pub_type: 杂志文章,评审
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journal_title:Clinical therapeutics
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pub_type: 杂志文章,评审
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journal_title:Clinical therapeutics
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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journal_title:Clinical therapeutics
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更新日期:2016-05-01 00:00:00
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1997-09-01 00:00:00
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journal_title:Clinical therapeutics
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:
更新日期:1993-09-01 00:00:00
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journal_title:Clinical therapeutics
pub_type: 临床试验,杂志文章
doi:
更新日期:1988-01-01 00:00:00
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journal_title:Clinical therapeutics
pub_type: 杂志文章
doi:
更新日期:1989-11-01 00:00:00
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pub_type: 杂志文章
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pub_type: 临床试验,杂志文章
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更新日期:2011-11-01 00:00:00
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pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期:1995-11-01 00:00:00
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pub_type: 杂志文章
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journal_title:Clinical therapeutics
pub_type: 杂志文章,随机对照试验
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更新日期:2009-03-01 00:00:00
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journal_title:Clinical therapeutics
pub_type: 临床试验,杂志文章
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更新日期:1983-01-01 00:00:00