Study Questions Cost-Effectiveness of RSV Treatment for Kids

May 07, 2002

A new study reveals that a strategy designed to prevent hospitalizations related to a common respiratory virus costs significantly more than hospitalizing the small percentage of children who develop serious forms of the illness. The research was presented Tuesday, May 7, at the Pediatric Academic Societies' annual meeting in Baltimore.

All children are susceptible to respiratory syncytial virus, commonly called RSV. For most, exposure leads to mild symptoms such as a cold, cough, or wheezing. Others, especially those born prematurely, are more likely to suffer serious complications, including a type of lung infection known as bronchiolitis.

Researchers from Golisano Children's Hospital at Strong set out to determine the cost-effectiveness of Synagis. The popular drug isn't a vaccine, but a sometimes-successful preventive measure that can reduce the hospitalization rate for children who have RSV.

"We found that it is more expensive to treat these children with Synagis in an attempt to prevent RSV hospitalization than it is to pay for the medical costs actually associated with hospitalization," says Nahed El-Hassan, M.D., a neonatology fellow at Golisano Children's Hospital. "For illustrative purposes, let's assume one clinic spends $47,000 to provide Synagis to 20 children for one RSV season. These efforts prevent an average of only one hospitalization, which costs less than $7,000. We knew treating these children was expensive and sometimes inefficient, but this was eye-opening."

Synagis helps some children avoid being hospitalized, but the percentage is low. For instance, says co-author Timothy Stevens, M.D., only 5 percent to 15 percent of premature babies derive significant benefit from the five drug injections during RSV season. "Synagis does not reduce mortality, which fortunately is very low," Stevens says. "The effects of the drug wear off in 30 to 60 days, and the baby is susceptible to the virus again the next RSV season. A vaccine that can provide long-term protection is needed."

Synagis treatment involves giving children monthly injections of the medicine during RSV season, which typically lasts from November through March.

The study's authors estimate it costs between $2,000 and $8,400 - depending on the child - to provide Synagis to one patient during a single RSV season. In comparison, it can cost less than $100 to provide a child with shots to prevent chicken pox.

"Certainly, Synagis provides some children with a great benefit," El-Hassan says. "What we need to do now is determine ways to target the treatment, so that those children who are most at risk are the ones receiving it. If we can identify those children and provide the drug to them, we'll make a big difference at a decreased cost."

The study, funded by Golisano Children's Hospital, was also co-authored by Melony Sorbero, Ph.D., Caroline Hall, M.D., and Andrew Dick, Ph.D.

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