Medical Outcomes and Research in Economics (MORE®), Sunnybrook Health Sciences Centre and Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada.
J Med Econ. 2010;13(3):453-63. doi: 10.3111/13696998.2010.499749.
Palivizumab is a prophylactic therapy shown to reduce the number of respiratory syncytial virus (RSV)-related hospitalizations but has a high acquisition cost. The objective was to systematically examine the cost effectiveness of palivizumab in defined infant groups and identify important cost and outcome determinants.
Literature searches of MedLine, the Cost-Effectiveness Analysis registry and the UK NHS Economic Evaluation Database (NHS EED) were conducted to identify economic evaluations of palivizumab compared to no prophylactic treatment for RSV prevention in any infant population. Study quality was evaluated using Quality of Health Economic Studies (QHES) criteria and results converted to 2009 CAN$ for comparison.
A total of 23 articles meeting inclusion criteria were identified, including 11 cost-utility analyses (CUAs) and 12 cost-effectiveness analyses (CEAs). Quality of individual analyses was fairly high (range 60-100, median 86). Results ranged from cost dominance for prophylaxis to $3,365,769/QALY depending on population, outcome measures, and input parameters. Base-case and sensitivity-analysis mortality rates varied between studies and influenced results.
RSV prophylaxis with palivizumab is cost effective in specific groups of high-risk infants, especially those with multiple environmental risk factors. Cost-effectiveness estimates vary between populations and settings and are more positive in those at highest risk for RSV hospitalization.
Direct comparison of the published reports was limited by restriction to English language articles and the varied methodologies, input measures, and populations across the studies reviewed. Although reported currencies were converted to a common unit for comparison, this does not completely account for monetary and inflation differences.
帕利珠单抗是一种预防性治疗药物，已被证明可降低呼吸道合胞病毒（RSV）相关住院人数，但获取成本较高。本研究旨在系统评估帕利珠单抗在特定婴儿群体中的成本效益，并确定重要的成本和结果决定因素。
检索 MedLine、成本效益分析登记处和英国国家卫生服务经济评价数据库（NHS EED），以确定比较帕利珠单抗与无 RSV 预防的预防性治疗的经济学评价，纳入所有婴儿人群。使用健康经济研究质量（QHES）标准评估研究质量，并将结果转换为 2009 年加拿大元进行比较。
共确定了 23 篇符合纳入标准的文章，包括 11 项成本效用分析（CUA）和 12 项成本效益分析（CEA）。单个分析的质量相当高（范围为 60-100，中位数为 86）。结果因人群、结局测量和输入参数而异，从预防治疗的成本优势到每 QALY 3365769 加元不等。基础案例和敏感性分析的死亡率在不同研究中存在差异，并影响结果。
帕利珠单抗用于预防 RSV 在特定高危婴儿群体中具有成本效益，尤其是那些存在多种环境危险因素的婴儿。成本效益估计在不同人群和环境中有所不同，在 RSV 住院风险最高的人群中更为积极。
由于受限于英语语言文章以及所审查研究的不同方法学、输入测量和人群，对已发表报告的直接比较受到限制。尽管报告的货币已转换为通用单位进行比较，但这并不能完全说明货币和通胀差异。
