Cost-effectiveness of respiratory syncytial virus prophylaxis with palivizumab

J Paediatr Child Health. 2006 May;42(5):253-8. doi: 10.1111/j.1440-1754.2006.00850.x.


Background: A monoclonal antibody, palivizumab, directed against respiratory syncytial virus (RSV) has been shown to decrease hospitalisation rates. Because of its expense, the cost-effectiveness of this agent should be determined for high-risk groups.

Aim: To determine characteristics of RSV infection in Townsville and the economic feasibility of palivizumab immunoprophylaxis in high-risk groups.

Methods: Cases of RSV-positive bronchiolitis were retrospectively identified. Cases were grouped according to recognised risk factors. The hypothetical costs of palivizumab immunoprophylaxis for infants at risk were calculated.

Results: The rate of hospitalisation with RSV-positive lower respiratory tract infection was 22 per 1000 live births but increased to 50 per 1000 among Indigenous babies born weighing <2500 g. The cost of preventing an admission in each of the identified high-risk groups, based on drug costs alone, ranged from AD 69,861 to AD 88,547.

Conclusion: Palivizumab was not cost-effective in the prophylaxis of RSV in the high-risk group of infants tested here.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Monoclonal / economics
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized
  • Antiviral Agents / economics
  • Antiviral Agents / therapeutic use*
  • Cost-Benefit Analysis
  • Drug Costs
  • Health Care Costs
  • Hospitalization / economics
  • Humans
  • Infant
  • Infant, Newborn
  • Length of Stay
  • Models, Economic
  • Native Hawaiian or Other Pacific Islander
  • Palivizumab
  • Patient Admission / statistics & numerical data
  • Premedication / economics*
  • Queensland / epidemiology
  • Queensland / ethnology
  • Respiratory Syncytial Virus Infections / epidemiology
  • Respiratory Syncytial Virus Infections / immunology
  • Respiratory Syncytial Virus Infections / prevention & control*
  • Respiratory Tract Infections / epidemiology
  • Respiratory Tract Infections / immunology
  • Respiratory Tract Infections / prevention & control*
  • Respiratory Tract Infections / virology
  • Retrospective Studies
  • Seasons


  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antiviral Agents
  • Palivizumab