NEW YORK (Reuters Health) - The $1,600 per dose price tag on a drug to prevent lung infection in premature babies may overshadow the benefit, according to a new study.
Premature babies are at the highest risk of hospitalization from RSV, or respiratory syncytial virus. They receive the highest benefit from the drug, said the study in the Archives of Pediatric and Adolescent Medicine.
But "even in this risk group, it costs more than $300,000 to prevent one hospitalization," said Christian Hampp, a co-author on the paper. The average cost to hospitalize a baby for the virus is around $9,000, he told Reuters Health.
Hampp worked on the research while he was at the University of Florida in Gainesville. Now he works for the Food and Drug Administration (FDA), but the FDA was not involved in the study.
Most kids will have RSV by the time they're two. Although it's usually not severe, RSV can sometimes lead to serious conditions, such as pneumonia.
Out of every 200 infants and children who are exposed to the virus, somewhere between one and four of them will end up in the hospital because of it, according to the Centers for Disease Control.
RSV causes between 170 and 510 deaths a year in the US, Hampp said.
The drug, palivizumab, is sometimes given to babies who are likely to get complications from RSV, such as preemies or babies with chronic lung disease or heart disease.
The researchers looked at Medicaid claims for about 159,000 kids in Florida up to age two. They tracked the number of hospitalizations between October 2004 and March 2005, when most cases of RSV in Florida occur. They found that nearly 3,000 children had received palivizumab, and around 1,000 had to be hospitalized.
Then they calculated the cost of using palivizumab to prevent hospitalization from the virus.
The total price tag of treating one preemie for six months was about $10,000. This brought a preemie's odds of hospitalization for RSV down from one in 25 to one in 100. But still, they would need to treat 26 babies for six months in order to prevent one case of hospitalization.
The drug is exclusively made by MedImmune, under the brand name Synagis. The price would have to come down to $47 per dose for the costs to even out, the researchers said.
MedImmune did not comment on the cost, but pointed out that the study has some limitations, such as relying on Medicaid claims information.
"Claims data is used for payment purposes rather than clinical diagnosis," MedImmune said in an email. Some RSV cases may be missed this way, they said, which might underestimate the benefit of the drug.
Because the dose the kids get of palivizumab depends on their weight, costs increased if the child was older. Preventing a single hospitalization could cost as much as two to three million dollars, depending on the child's age and risk.
This study looked at the economic costs only, and did not take into effect emotional costs for the parents or pain and suffering of the babies.
Other studies in the past have looked at the costs of RSV preventative drugs, said Dr. Caroline Hall, professor of pediatrics at the University of Rochester School of Medicine in New York. She was not involved in Hampp's study.
The range of costs have varied, but "I don't think any of them have shown that it's cost effective," Hall said.
SOURCE: http://bit.ly/gdby5x the Archives of Pediatric and Adolescent Medicine, online February 7, 2011.