Objectives To assess the cost effectiveness of palivizumab prophylaxis used to prevent RSV hospitalization (RSVH) in infants with hemodynamically significant congenital heart disease (CHD) in the German healthcare setting.

Methods The cost effectiveness of palivizumab for a hypothetical cohort of patients was estimated with a decision tree model. Data sources included published literature, palivizumab pivotal trials, official price/tariff lists and national population statistics. The study was conducted from the perspective of society (primary analysis) and the healthcare purchaser (secondary analysis).

Results From the societal perspective, use of palivizumab results in an incremental cost-effectiveness ratio (ICER) of ?2,615 per quality-adjusted life-year (QALY) without discounting, which increases to ?9,529/QALY after discounting. From the perspective of the German healthcare purchaser, use of palivizumab results in an ICER of ?4,576/QALY without discounting, which increases to ?16,673/QALY after discounting. Probabilistic sensitivity analyses confirmed the robustness of the model.

Conclusion This analysis showed that palivizumab represents a cost-effective means of prophylaxis against RSVH in infants with hemodynamically significant CHD.

Funded by Abbott.