Introduction:

Palivizumab is a prophylactic monoclonal antibody against respiratory syncytial virus of high cost and unknown efficacy.

Objective:

To evaluate the efficiency of immunotherapy with palivizumab in preterm infants in the Costa Rican social security system.

Methods:

A full economic evaluation was conducted in the period 2010-2017, with a time horizon of one year, no discount rate from the perspective of social security and cost data in US dollars. Seven high-complexity hospitals were included and complemented by a budget impact analysis (2018-2021). Selected clinical records were reviewed after the attrition procedure of preterm infants receiving palivizumab (n = 200) and preterm infants receiving the traditional clinical alternative (n = 206). The simplest sensitivity analysis was performed which is univariate by considering the mean value plus minus two standard deviations.

Results:

The majority of preterm infants belonged to low-income households and mothers with low educational level. Efficiency was favourable for innovative palivizumab therapy by generating health benefits according to gestational age group and hospital stay. The average cost of treatment was highly sensitive to a range of factors. Universalisation of immunotherapy generated increases in institutional budget commensurate with the scenario selected.

Conclusions:

The use of palivizumab is an efficient alternative according to the gestational age of the preterm infant and hospital stay, with generalised use producing a budget increase that must be weighed given the benefits obtained.

        · resumen en Español     · texto en Español     · Español ( pdf )