Comparison of the cost of hospitalization for respiratory syncytial virus disease versus palivizumab prophylaxis in Canadian Inuit infants

Pediatr Infect Dis J. 2009 Aug;28(8):702-6. doi: 10.1097/INF.0b013e31819df78e.


Background: The objectives were to compare actual respiratory syncytial virus (RSV) hospitalization rates and costs in a cohort of Inuit infants to hypothetical palivizumab prophylaxis strategies for infants of all gestational ages in the Eastern Canadian Arctic.

Methods: Incidence and costs of RSV hospitalization were collected for infants admitted to the Baffin Regional Hospital in 2002, before the initiation of palivizumab. There was a comparison of the actual costs to the costs associated with 8 palivizumab strategies stratified by age (<6 months, <1 year) and location (overall, town [Iqaluit], rural communities). It was assumed that each category would receive universal palivizumab prophylaxis resulting in a 78% decrease in RSV admissions. The net costs incurred, number needed to treat (NNT), and incremental costs per hospitalization avoided were calculated for each comparison.

Results: There was a great variation in the rates and costs associated with RSV admissions between Iqaluit and the communities. For infants <1 year of age residing in Iqaluit, the mean admission cost was $3915, and palivizumab prophylaxis had an NNT of 20.4 and cost of $162,551 per admission avoided. For rural infants <6 months, the mean cost of admission was $23,030, and palivizumab prophylaxis resulted in an NNT of 3.9 to 2.5 and cost savings of up to $8118 per admission avoided.

Conclusions: Due to the high rates and costs associated with RSV admissions, administration of palivizumab in rural communities in the Canadian Arctic to infants less than 6 months of age could result in net cost savings.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibiotic Prophylaxis / economics*
  • Antibodies, Monoclonal / economics
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized
  • Antiviral Agents / economics
  • Antiviral Agents / therapeutic use
  • Canada
  • Hospitalization / economics*
  • Humans
  • Infant
  • Inuit*
  • Palivizumab
  • Respiratory Syncytial Virus Infections / drug therapy
  • Respiratory Syncytial Virus Infections / economics*
  • Respiratory Syncytial Virus Infections / ethnology
  • Respiratory Syncytial Virus Infections / prevention & control
  • Respiratory Syncytial Viruses / isolation & purification*
  • Respiratory Tract Infections / drug therapy
  • Respiratory Tract Infections / economics*
  • Respiratory Tract Infections / prevention & control
  • Respiratory Tract Infections / virology


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