Schrand L M, Elliott J M, Ross M B, Bell E F, Mutnick A H
Department of Pharmaceutical Care, University of Iowa Hospitals and Clinics, Iowa City, USA.
Ann Pharmacother. 2001 Oct;35(10):1186-93. doi: 10.1345/aph.10374.
To determine the cost and benefit of using RSV-IG and palivizumab as prophylactic therapy against respiratory syncytial virus (RSV)-associated illness in high-risk infants.
A nonrandomized, retrospective, cohort control study was conducted comparing the outcomes of patients who received either RSV-IG or palivizumab therapy against RSV during the 1998-1999 RSV season with patients identified from the 1994-1995 RSV season who would have been eligible to receive prophylaxis had either agent been available at that time. Medical record reviews were conducted to gather data regarding the costs associated with both the administration of the prophylactic drugs and the treatment of RSV-associated hospitalizations in both groups. Decision analysis was used to determine the average cost per patient for both groups. A cost-benefit analysis was then conducted to determine the return on investment, if any, for the use of these drugs. A sensitivity analysis was also conducted to determine the robustness of the data.
Patients who received RSV-IG or palivizumab had a hospitalization rate of 1.6% compared with 25% for the group who did not receive prophylactic drugs. The average costs for the RSV prophylaxis group were less per patient $3,733 compared with $4,258 in the group who did not receive prophylaxis. The benefit is a 23.4% lower chance of hospitalization for each infant or, in dollar figures, $3,985 ($17,031 x 0.234). The benefit-cost ratio is 1.15:1 ($3,985:3,461). The benefits, therefore, exceed the costs associated with the prophylaxis program. The prophylaxis program saved healthcare dollars by preventing RSV-related hospital-izations.
Results demonstrate that when used according to our institution's criteria, RSV prophylaxis is of benefit to our institution.
确定使用呼吸道合胞病毒免疫球蛋白（RSV-IG）和帕利珠单抗作为高危婴儿呼吸道合胞病毒（RSV）相关疾病预防性治疗的成本和效益。
进行了一项非随机、回顾性队列对照研究，比较1998 - 1999年RSV流行季接受RSV-IG或帕利珠单抗预防RSV治疗的患者与1994 - 1995年RSV流行季中符合条件（若当时有这两种药物其中一种则可接受预防治疗）的患者的结局。进行病历审查以收集两组中预防性药物给药及RSV相关住院治疗的成本数据。采用决策分析确定两组患者的人均成本。然后进行成本效益分析以确定使用这些药物的投资回报率（如有）。还进行了敏感性分析以确定数据的稳健性。
接受RSV-IG或帕利珠单抗治疗的患者住院率为1.6%，而未接受预防性药物治疗的组住院率为25%。RSV预防组的人均成本为3733美元，低于未接受预防治疗组的4258美元。效益是每个婴儿住院几率降低23.4%，以美元计算为3985美元（17031美元×0.234）。效益成本比为1.15:1（3985美元:3461美元）。因此，效益超过了预防计划的相关成本。预防计划通过预防与RSV相关的住院治疗节省了医疗费用。
结果表明，按照我们机构的标准使用时，RSV预防对我们机构有益。
