Cost effectiveness analysis of respiratory syncytial virus infection prophylaxis in children with congenital heart disease
Cost effectiveness analysis of respiratory syncytial virus infection prophylaxis in children with congenital heart disease
Data
2014
Autores
Cintra, MACT
Santos, MS
Correia, MG
Tura, BR
Journal Title
Journal ISSN
Volume Title
Publisher
Value in Health
Resumo
Objectives: Respiratory syncytial virus (RSV) is the leading cause of acute lower
respiratory illness in children under two years of age. In Brazil, the VSR is the cause
of 54.1% of all hospitalizations for pneumonia /bronchiolitis in infants under one
year old, reaching up to 70% during the epidemic periods. Congenital heart disease
(CHD) is an important risk factor for morbidity and mortality of RSV infection. This
study performed a cost effectiveness analysis of Palivizumab (PVZ) to prevent RSV
infection in infants undergoing cardiac surgery for correction of CHD. Methods:
Three Systematic Reviews (SR) of literature were performed, in Medline, Cochrane
and LILACS, for efficacy, safety of PVZ and the prevalence of RSV in infants in Brazil.
The economic evaluation developed a decision analytic model to estimate the cost effectiveness ratio of using PVZ for prophylaxis of RSV infection in children under going cardiac surgery, from the perspective of Public Health System, with the time
horizon of the postoperatively period. Results: Efficacy search (478 titles) showed
that PVZ reduces hospitalization for children with CHD by 45%. Safety search (67
titles) showed that the PVZ is safe for this population and the prevalence of RSV in
Brazil search (120 titles) showed that in children hospitalized with lower respiratory
tract infection there is a prevalence of 24.35% of RSV infection. The analytical model
showed an incremental cost-effectiveness ratio of USD863.3 per day of hospitalization
avoided and incremental cost-effectiveness ratio of USD132,398.9 per complication
avoided. Conclusions: The prevalence of RSV in Brazil is 24.35%. PVZ was effective
and safe to prevent severe RSV infection in children under two years of age with CHD,
but at a high cost to avoid an outcome. Its use has shown a significant decrease in
hospitalization of children receiving medication. Studies published worldwide are
controversial, requiring discussion for the implementation of the therapy in Brazil.
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Citação
Cintra MACT, Santos MS, Correia MG, Tura BR. Cost effectiveness analysis of respiratory syncytial virus infection prophylaxis in children with congenital heart disease. Value Health. 2014;17:A176.