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2020, Number 2

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Rev Cubana Farm 2020; 53 (2)

Economic evaluation of palivizumab treatment in premature infants in the Social Security of Costa Rica, 2013-2017

Jiménez HLG, Collazo HM, Gálvez GA

Language: Spanish
References: 43
Page: 1-23
PDF size: 492.72 Kb.


ABSTRACT

Introduction: Respiratory syncytial virus affects the health of premature infants. Palivizumab can reduce its complications. In Costa Rica, the efficiency of using this health technology is unknown.
Objective: To evaluate the efficiency of prophylactic administration of palivizumab in premature infants versus traditional or usual clinical practice in the Costa Rican Social Security Fund, between 2013-2017.
Methods: An economic cost-effectiveness evaluation was carried out, from a socialsecurity approach (7 hospitals), with a one-year time horizon and without discount rate. The study population consisted of 173 premature infants: 38 were treated with palivizumab; and 135, without palivizumab. The clinical data were weight at birth, gestational age, bronchopulmonary dysplasia, and congenital heart disease. The cost data expressed in US dollars were medications, medical consultation, and diagnostic test. Effectiveness was assessed by the number of hospitalization days, oxygen therapy, mechanical ventilation, bronchiolitis episodes, pneumonia, and deaths. The analyzes considered the decision tree, average and incremental cost-effectiveness, as well as of sensitivity.
Results: Premature infants treated with palivizumab showed lower frequency in all the effectiveness variables, the decision tree showed an incremental cost-effectiveness of 78 US dollars, and mean cost-effectiveness was higher in premature infants treated with palivizumab. One additional hospitalization day with palivizumab treatment has a cost of 823 US dollars, while, in the intensive care unit, its cost represents 72 154 US dollars.
Conclusions: Palivizumab produces health benefits for premature infants, in line with health policies in Costa Rica and worldwide. This technology can be considered as efficient in the social security of Costa Rica, insofar it generates health benefits that outweigh the costs circumscribed to the changes that occur in various aspects such as the number and conditions of premature infants who receive it, virus seasonality, or treatment cost.


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