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The Economics of Strategies to Reduce Respiratory Syncytial Virus Hospitalizations in Alaska.
Borse, Rebekah H; Singleton, Rosalyn J; Bruden, Dana T; Fry, Alicia M; Hennessy, Thomas W; Meltzer, Martin I.
Affiliation
  • Borse RH; Division of Preparedness and Emerging Infections.
  • Singleton RJ; Arctic Investigations Program, National Center for Emerging and Zoonotic Infectious Diseases.
  • Bruden DT; Arctic Investigations Program, National Center for Emerging and Zoonotic Infectious Diseases.
  • Fry AM; Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
  • Hennessy TW; Arctic Investigations Program, National Center for Emerging and Zoonotic Infectious Diseases.
  • Meltzer MI; Division of Preparedness and Emerging Infections.
J Pediatric Infect Dis Soc ; 3(3): 201-12, 2014 Sep.
Article de En | MEDLINE | ID: mdl-26625383
BACKGROUND: Alaska Native infants experience high rates of respiratory syncytial virus (RSV) hospitalizations. Through 2008, Alaska administered a 7-dose (maximum) palivizumab regime to high-risk infants from October to May. In 2009, the maximum was reduced to 3 doses for 32- to 34-week preterm babies and 6 doses for other groups. METHODS: We used 11 years of data and regional Medicaid reimbursement rates to model the cost effectiveness of 4 palivizumab intervention strategies to reduce RSV hospitalizations among Alaskan infants including: current strategy, old strategy (1998-2008), and 2 hypothetical strategies using the current strategy plus 1 or 3 doses to all newborn infants during the RSV season. RESULTS: The current strategy represents 5 hospitalizations averted per year for the palivizumab cohort (∼50-56 children) at ∼$52 846 per hospitalization averted, compared with no intervention. Compared with the old strategy, the mean cost per hospitalization prevented for the current strategy was 63% lower, net program costs were 85% lower, and the mean hospitalizations prevented were 27% lower. Compared with current strategy only, the addition of 1 dose to all newborns during the RSV season could decrease the mean cost per hospitalization prevented by 23%, increase the number of hospitalizations prevented by 2.5-fold, and increase the net programmatic costs by 3.3-fold; administering up to 3 doses to infants further reduced hospitalizations and increased costs. CONCLUSIONS: The current palivizumab strategy improved the cost-effectiveness ratio compared with the old strategy. Further improvement could be obtained by adding doses for Alaskan Native newborns during the RSV season; however, programmatic costs would increase.
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Texte intégral: 1 Collection: 01-internacional Base de données: MEDLINE Type d'étude: Health_economic_evaluation / Prognostic_studies Langue: En Journal: J Pediatric Infect Dis Soc Année: 2014 Type de document: Article Pays de publication: Royaume-Uni

Texte intégral: 1 Collection: 01-internacional Base de données: MEDLINE Type d'étude: Health_economic_evaluation / Prognostic_studies Langue: En Journal: J Pediatric Infect Dis Soc Année: 2014 Type de document: Article Pays de publication: Royaume-Uni