Palivizumab has proven effective in reducing hospitalizations, preventing severe illness, improving health outcomes, and reducing healthcare costs for infants at risk of respiratory syncytial virus (RSV) infection. We aim to assess the value of palivizumab in preventing RSV infection in high-risk infants in Colombia, where RSV poses a significant threat, causing severe respiratory illness and hospitalizations. We conducted a decision tree analysis to compare five doses of palivizumab with no palivizumab. The study considered three population groups: preterm neonates (≤ 35 weeks gestational age), infants with bronchopulmonary dysplasia (BPD), and infants with hemodynamically significant congenital heart disease (CHD). We obtained clinical efficacy data from IMpact-RSV and Cardiac Synagis trials, while we derived neonatal hospitalization risks from the SENTINEL-1 study. We based hospitalization and recurrent wheezing management costs on Colombian analyses and validated them by experts. We estimated incremental cost-effectiveness ratios and performed 1,000 Monte Carlo simulations for probabilistic sensitivity analyses. Palivizumab is a dominant strategy for preventing RSV infection in preterm neonates and infants with BPD and CHD. Its high efficacy (78% in preventing RSV in preterm infants), the substantial risk of illness and hospitalization, and the high costs associated with hospitalization, particularly in neonatal intensive care settings, support this finding. The scatter plots and willingness-to-pay curves align with these results. Palivizumab is a cost-saving strategy in Colombia, effectively preventing RSV infection in preterm neonates and infants with BPD and CHD by reducing hospitalizations and lowering healthcare costs.

中文翻译：

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帕利珠单抗预防哥伦比亚早产儿和婴儿呼吸道合胞病毒的成本效益分析

事实证明，帕利珠单抗可有效减少住院治疗、预防严重疾病、改善健康结果，并降低有呼吸道合胞病毒 (RSV) 感染风险的婴儿的医疗费用。我们的目的是评估帕利珠单抗在预防哥伦比亚高危婴儿 RSV 感染方面的价值，在哥伦比亚，RSV 构成重大威胁，导致严重呼吸道疾病和住院治疗。我们进行了决策树分析，以比较五种剂量的帕利珠单抗与无帕利珠单抗的情况。该研究考虑了三个人群：早产儿（≤ 35 周胎龄）、患有支气管肺发育不良 (BPD) 的婴儿和患有血流动力学显着的先天性心脏病 (CHD) 的婴儿。我们从 IMpact-RSV 和 Cardiac Synagis 试验中获得了临床疗效数据，同时从 SENTINEL-1 研究中得出了新生儿住院风险。我们根据哥伦比亚的分析确定了住院治疗和反复喘息管理费用，并由专家进行了验证。我们估算了增量成本效益比，并进行了 1,000 次蒙特卡罗模拟以进行概率敏感性分析。帕利珠单抗是预防早产儿以及 BPD 和 CHD 婴儿 RSV 感染的主要策略。其高功效（预防早产儿 RSV 的效率为 78%）、患病和住院的巨大风险以及与住院相关的高费用（特别是在新生儿重症监护环境中）都支持了这一发现。散点图和支付意愿曲线与这些结果一致。帕利珠单抗是哥伦比亚的一种节省成本的策略，通过减少住院治疗和降低医疗费用，有效预防早产新生儿以及患有 BPD 和 CHD 的婴儿的 RSV 感染。