Cost effectiveness of palivizumab for RSV prevention in high-risk children in the Netherlands

Figures & data

Figure 1. Treatment pathway for CHD indication (model structure for the pretem/BPD indication is similar).

Table 1. Hospitalisation inputs.

Hospitalisation	Probability (%)		p-value	Reference
Base-case analysis	Palivizumab	Placebo
Overall preterm/BPD	4.8	10.6	<0.001	21
Preterm, excluding BPD	1.8	8.1	<0.01	21
BPD	7.9	12.8	0.001	21
CHD	5.3	9.7	0.003	22
Scenario analyses	RSV immune globulin	Placebo
Preterm/BPD/CHD	7.4	20.2	0.02	28
Preterm/BPD	8.0	13.5	0.047	29
CHD	10.0	15.0	0.16	30

BPD, bronchopulmonary dysplasia; CHD, congenital heart disease; NS, not significant.

Figure 2. Average costs (direct and indirect) per child.

Table 2. Cost-effectiveness results (QALYs) – preterm/BPD population.

Cost effectiveness	Costs (€)	No discounting		Discounting
		Outcomes	ICER (€)	Outcomes	ICER (€)
Direct medical costs including asthma
Base-case analysis	5,369	0.42	12,728	0.27	20,236
Groothuis scenario	5,186	0.80	6,455	0.51	10,269
PREVENT scenario	5,314	0.54	9,926	0.34	15,784
Total costs
Base-case analysis	3,007	0.42	7,130	0.27	11,336
Groothuis scenario	681	0.80	847	0.51	1,348
PREVENT scenario	2,316	0.54	4,325	0.34	6,878

Table 3. Cost-effectiveness results (QALYs) – CHD population.

Cost-effectiveness outcome	Costs (€)	No discounting		Discounting
		Outcomes	ICER (€)	Outcomes	ICER (€)
Direct medical costs including asthma
Base-case analysis	5,926	1.39	4,256	0.84	7,067
CARDIAC scenario	5,771	2.15	2,683	1.29	4,458
Total costs
Base-case analysis	–2,670	1.39	Dominant	0.84	Dominant
CARDIAC scenario	–7,521	2.15	Dominant	1.29	Dominant

Figure 3. Sensitivity analyses – preterm/BPD population.

Figure 4. Sensitivity analyses – CHD population.

Figure 5. Cost-effectiveness acceptability curve (preterm/BPD).

Figure 6. Cost-effectiveness acceptability curve (CHD).