The AAP issued guidelines for prophylactic use of RSV-Ig for infants with BPD and preterm infants without BPD because RSV-Ig decreased RSV-hosp by 41-65%. We calculated RSV-hosp risk and cost analysis of RSV prophylaxis for infants born ≤32 wk GA in the 1st yr after NICU discharge. In the past 5 yr, 130 NICU grads were readmitted in their 1st year with an RSV-associated illness (RSV-ai), representing 23.6% (130/552) of all RSV-hosp and 2.5%(130/5139) of all NICU discharges. Readmission hospital charges for the 53 infants ≤32 wk were compared with the estimated cost of prophylaxis($5,000/patient/yr). Using an expected 53% reduction in RSV-hosp with prophylaxis, we calculated cost/hosp prevented. The proportion of infants with RSV-hosp in each GA group was compared to the proportion of infants of older GA with RSV-hosp. Infants ≤30 wk surviving to discharge are significantly more likely to be readmitted with an RSV-ai than older infants. However, the estimated cost of RSV-Ig prophylaxis greatly exceeds anticipated hospital charges. The cost of prophylaxis per hospital admission prevented may prove prohibitive. Further analysis of subsets of preterm infants with BPD may yield a more cost-effective approach to preventing RSV infection in high risk infants. Table

Table 1
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