IDEAS home Printed from https://ideas.repec.org/a/spr/hecrev/v7y2017i1d10.1186_s13561-017-0181-3.html
   My bibliography  Save this article

Palivizumab in the prevention of severe respiratory syncytial virus infection in children with congenital heart disease; a novel cost-utility modeling study reflecting evidence-based clinical pathways in Spain

Author

Listed:
  • Ralph Schmidt

    (Pharmerit International, Health Economics and Outcomes Research)

  • Istvan Majer

    (Pharmerit International, Health Economics and Outcomes Research)

  • Natalia García Román

    (AbbVie, Medical Department)

  • Alejandra Rivas Basterra

    (AbbVie, Government Affairs and Market Access)

  • ElizaBeth Grubb

    (AbbVie, Health Economics and Outcomes Research)

  • Constancio Medrano López

    (Gregorio Marañón University Hospital)

Abstract

Background Respiratory syncytial virus (RSV) infection remains one of the major reasons of re-hospitalization among children with congenital heart disease (CHD). This study estimated the cost-effectiveness of palivizumab prophylaxis versus placebo, in Spain, from the societal perspective, using a novel cost-effectiveness model reflecting evidence-based clinical pathways. Methods A decision-analytic model, combining a decision tree structure in the first year and a Markov structure in later years, was constructed to evaluate the benefits and costs associated with palivizumab versus no prophylaxis among children with CHD. In the first year of the model, children were at risk of mild (i.e. medically attended, MA-RSV) and severe (hospitalized, RSV-H) RSV infection. The impact of delayed corrective CHD surgery due to RSV infection and the consequence of performed surgery despite severe infection were considered. In later years, patients were at risk of developing asthma and allergic sensitization as sequelae of RSV infection. Input data for the model were derived from the pivotal clinical trial and systematic literature reviews. Indirect costs included parental absence from work and nosocomial infections. In agreement with Spanish guidelines, costs and effects were discounted at 3%. Results Over a lifetime horizon, palivizumab prophylaxis yielded 0.11 and 0.07 additional quality-adjusted life years (QALYs) and life years (LYs), respectively, at additional costs of € 1,693, resulting in an ICER of € 15,748 per QALY gained and € 24,936 per LY gained. Probabilistic sensitivity analyses demonstrated that the probability of palivizumab prophylaxis being cost-effective at a € 30,000 per QALY threshold was 92.7%. The ICER remained below this threshold for most extreme scenario analyses. Conclusions The model demonstrated that palivizumab prophylaxis results in more QALYs than no prophylaxis in children with CHD. Palivizumab prophylaxis was shown to be a cost-effective health care intervention according to the commonly accepted standards of cost-effectiveness in Spain (ICER below the threshold of € 30,000 per QALY).

Suggested Citation

  • Ralph Schmidt & Istvan Majer & Natalia García Román & Alejandra Rivas Basterra & ElizaBeth Grubb & Constancio Medrano López, 2017. "Palivizumab in the prevention of severe respiratory syncytial virus infection in children with congenital heart disease; a novel cost-utility modeling study reflecting evidence-based clinical pathways," Health Economics Review, Springer, vol. 7(1), pages 1-14, December.
  • Handle: RePEc:spr:hecrev:v:7:y:2017:i:1:d:10.1186_s13561-017-0181-3
    DOI: 10.1186/s13561-017-0181-3
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1186/s13561-017-0181-3
    File Function: Abstract
    Download Restriction: no

    File URL: https://libkey.io/10.1186/s13561-017-0181-3?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Anthony Bentley & Ivana Filipovic & Katherine Gooch & Katharina Büsch, 2013. "A cost-effectiveness analysis of respiratory syncytial virus (RSV) prophylaxis in infants in the United Kingdom," Health Economics Review, Springer, vol. 3(1), pages 1-12, December.
    2. Julio López-Bastida & Juan Oliva & Fernando Antoñanzas & Anna García-Altés & Ramón Gisbert & Javier Mar & Jaume Puig-Junoy, 2010. "Spanish recommendations on economic evaluation of health technologies," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(5), pages 513-520, October.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. M. Barbieri & H. Weatherly & R. Ara & H. Basarir & M. Sculpher & R. Adams & H. Ahmed & C. Coles & T. Guerrero-Urbano & C. Nutting & M. Powell, 2014. "What is the Quality of Economic Evaluations of Non-Drug Therapies? A Systematic Review and Critical Appraisal of Economic Evaluations of Radiotherapy for Cancer," Applied Health Economics and Health Policy, Springer, vol. 12(5), pages 497-510, October.
    2. Rivero-Santana, Amado & Cuéllar-Pompa, Leticia & Sánchez-Gómez, Luis M. & Perestelo-Pérez, Lilisbeth & Serrano-Aguilar, Pedro, 2014. "Effectiveness and cost-effectiveness of different immunization strategies against whooping cough to reduce child morbidity and mortality," Health Policy, Elsevier, vol. 115(1), pages 82-91.
    3. B. Rodríguez-Sánchez & S. Daugbjerg & L. M. Peña-Longobardo & J. Oliva-Moreno & I. Aranda-Reneo & A. Cicchetti & J. López-Bastida, 2023. "Does the inclusion of societal costs change the economic evaluations recommendations? A systematic review for multiple sclerosis disease," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 24(2), pages 247-277, March.
    4. Ali Tafazzoli & Odette S. Reifsnider & Leana Bellanca & Jack Ishak & Marc Carrasco & Pal Rakonczai & Matthew Stargardter & Stephan Linden, 2023. "A European multinational cost-effectiveness analysis of empagliflozin in heart failure with reduced ejection fraction," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 24(9), pages 1441-1454, December.
    5. Colette Mankowski & Sachin Patel & David Trueman & Anthony Bentley & Chris Poole, 2016. "Cost-Effectiveness of Capsaicin 8% Patch Compared with Pregabalin for the Treatment of Patients with Peripheral Neuropathic Pain in Scotland," PLOS ONE, Public Library of Science, vol. 11(3), pages 1-16, March.
    6. Kobelt, G., 2013. "Health Economics: An Introduction to Economic Evaluation," Monographs, Office of Health Economics, number 000004.
    7. Yumi Asukai & Andrew Briggs & Louis P. Garrison & Benjamin P. Geisler & Peter J. Neumann & Daniel A. Ollendorf, 2021. "Principles of Economic Evaluation in a Pandemic Setting: An Expert Panel Discussion on Value Assessment During the Coronavirus Disease 2019 Pandemic," PharmacoEconomics, Springer, vol. 39(11), pages 1201-1208, November.
    8. Koen B Pouwels & Sefika E Bozdemir & Selen Yegenoglu & Solmaz Celebi & E David McIntosh & Serhat Unal & Maarten J Postma & Mustafa Hacimustafaoglu, 2016. "Potential Cost-Effectiveness of RSV Vaccination of Infants and Pregnant Women in Turkey: An Illustration Based on Bursa Data," PLOS ONE, Public Library of Science, vol. 11(9), pages 1-15, September.
    9. Puig-Junoy, Jaume & López-Valcárcel, Beatriz González, 2014. "Launch prices for new pharmaceuticals in the heavily regulated and subsidized Spanish market, 1995–2007," Health Policy, Elsevier, vol. 116(2), pages 170-181.
    10. Bengt Jönsson & Grace Hampson & Jonathan Michaels & Adrian Towse & J.-Matthias Graf Schulenburg & Olivier Wong, 2019. "Advanced therapy medicinal products and health technology assessment principles and practices for value-based and sustainable healthcare," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(3), pages 427-438, April.
    11. Leticia García-Mochón & Zuzana Špacírová & Jaime Espín, 2022. "Costing methodologies in European economic evaluation guidelines: commonalities and divergences," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(6), pages 979-991, August.
    12. SeungJin Bae & SooOk Lee & Eun Bae & Sunmee Jang, 2013. "Korean Guidelines for Pharmacoeconomic Evaluation (Second and Updated Version)," PharmacoEconomics, Springer, vol. 31(4), pages 257-267, April.
    13. Antonio García-Ruiz & Lucía Pérez-Costillas & Ana Montesinos & Javier Alcalde & Itziar Oyagüez & Miguel Casado, 2012. "Cost-effectiveness analysis of antipsychotics in reducing schizophrenia relapses," Health Economics Review, Springer, vol. 2(1), pages 1-12, December.
    14. Laura Amanda Vallejo-Aparicio & Jesús Molina & Iñigo Ojanguren & Ana Viejo Casas & Alicia Huerta & Henrik Svedsater, 2020. "Cost–consequence analysis of fluticasone furoate/vilanterol for asthma management in Spain: an analysis based on the Salford Lung Study in asthma," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(1), pages 7-17, February.
    15. Santiago Grau & Rafael Cámara & Manuel Jurado & Jaime Sanz & Belén Aragón & Irmina Gozalbo, 2018. "Cost-effectiveness of posaconazole tablets versus fluconazole as prophylaxis for invasive fungal diseases in patients with graft-versus-host disease after allogeneic hematopoietic stem cell transplant," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(4), pages 627-636, May.
    16. Erik Nord, 2011. "Discounting future health benefits: the poverty of consistency arguments," Health Economics, John Wiley & Sons, Ltd., vol. 20(1), pages 16-26, January.
    17. Lisanne I. Lier & Judith E. Bosmans & Hein P. J. Hout & Lidwine B. Mokkink & Wilbert B. Hout & G. Ardine Wit & Carmen D. Dirksen & Henk L. G. R. Nies & Cees M. P. M. Hertogh & Henriëtte G. Roest, 2018. "Consensus-based cross-European recommendations for the identification, measurement and valuation of costs in health economic evaluations: a European Delphi study," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(7), pages 993-1008, September.
    18. José Rodríguez Barrios & Ferran Pérez Alcántara & Carlos Crespo Palomo & Paloma González García & Enrique Antón De Las Heras & Max Brosa Riestra, 2012. "The use of cost per life year gained as a measurement of cost-effectiveness in Spain: a systematic review of recent publications," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(6), pages 723-740, December.
    19. Blanca Gros & Antonio Galán & Emilio González-Parra & Jose Herrero & Maria Echave & Stefan Vegter & Keith Tolley & Itziar Oyagüez, 2015. "Cost effectiveness of lanthanum carbonate in chronic kidney disease patients in Spain before and during dialysis," Health Economics Review, Springer, vol. 5(1), pages 1-9, December.
    20. Pascal Crépey & Esther Redondo & Javier Díez-Domingo & Raúl Ortiz de Lejarazu & Federico Martinón-Torres & Ángel Gil de Miguel & Juan Luis López-Belmonte & Fabián P Alvarez & Hélène Bricout & Míriam S, 2020. "From trivalent to quadrivalent influenza vaccines: Public health and economic burden for different immunization strategies in Spain," PLOS ONE, Public Library of Science, vol. 15(5), pages 1-19, May.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:hecrev:v:7:y:2017:i:1:d:10.1186_s13561-017-0181-3. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com/economics/journal/13561 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.