Abstract
Introduction: Prescription of palivizumab varies throughout the UK. Concern regarding the high price of RSV prophylaxis compared to possible savings from preventing an admission is cited as a reason to restrict palivizumab prescription. We report a method for minimising drug costs, achieving a 16% reduction with no adverse impact on clinical effectiveness.
Aims: To tightly coordinate the delivery of palivizumab prophylaxis, reducing drug wastage by cohorting and vial sharing.
Methods: We identified barriers to efficient cohorting through audit of previous experience and appointed a trainee to coordinate a programme of clinics to deliver RSV prophylaxis. Prior to the start of the season we agreed referral criteria, improved the referral process and sent explanatory letters to parents and general practitioners. Initial referrals were split into three groups who attended on consecutive afternoons for their first dose. Infants who were inpatients for part or all of the season were identified and dosed along with main cohorts. Infants continued to be referred throughout the season and new cohorts were created, timed to join a main cohort after the first dose where possible. Non-attenders were contacted by the coordinator and re-appointed to join another group.
Results: We began with three cohorts and ended with eight without compromising dosage intervals. We reduced drug wastage by 14% with a monetary saving of 16%. Over the whole season we dispensed 34,300mg and delivered 32,570mg in 356 doses to 114 patients at a total drug cost of £220,847, discarding only 1,730 mg (5%). Without vial sharing we would have dispensed 39,900mg and spent a further £41,527. Five patients were hospitalised with RSV (4.4%) which is in line with the published efficacy of palivizumab prophylaxis.
Conclusions: We have minimised drug costs effectively through strict cohorting and vial sharing, positively contributing to the cost-benefit analysis of RSV prophylaxis.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Wills, S., Coutts, J. & Simpson, J. 420 Cost Minimisation of Respiratory Syncitial Virus Prophylaxis with Palivizumab. Pediatr Res 58, 426 (2005). https://doi.org/10.1203/00006450-200508000-00449
Issue Date:
DOI: https://doi.org/10.1203/00006450-200508000-00449