Table 5 Results of the scenario analyses, incremental costs, outcomes, and incremental cost-effectiveness ratios
Scenario | Incremental costs | Incremental QALYs | Incremental LYs | ICER (QALYs) | ICER (LYs) |
|---|---|---|---|---|---|
Base case scenario | € 1693 | 0.11 | 0.07 | € 15,748 | € 24,936 |
Model setting parameters | |||||
Discount rate: 1.5% | € 1610 | 0.14 | 0.10 | € 11,252 | € 16,005 |
Discount rate: 5% | € 1783 | 0.08 | 0.05 | € 22,009 | € 38,971 |
Time horizon: 10 years | € 1693 | 0.05 | 0.02 | € 33,654 | € 77,789 |
Time Horizon: 30 years | € 1693 | 0.09 | 0.05 | € 19,307 | € 36,405 |
Clinical parameters | |||||
10% (relative) lower RSV-H rate | € 1808 | 0.10 | 0.06 | € 18,364 | € 29,595 |
Palivizumab efficacy (RSV-H) at lower 95% confidence interval limit | € 1916 | 0.09 | 0.05 | € 21,300 | € 35,024 |
Palivizumab efficacy (RSV-H) at upper 95% confidence interval limit | € 1415 | 0.13 | 0.08 | € 10,952 | € 16,805 |
Case fatality based on Wang et al. (3.72%) [54] | € 1673 | 0.09 | 0.05 | € 18,720 | € 34,629 |
Case fatality +1% higher in no prophylaxis group | € 1721 | 0.13 | 0.10 | € 12,841 | € 17,825 |
No general population background mortality in 1st year | € 1572 | 0.11 | 0.07 | € 14,133 | € 23,155 |
Allergic sensitization excluded | € 1923 | 0.09 | 0.07 | € 22,055 | € 28,328 |
All respiratory sequelae excluded | € 2209 | 0.08 | 0.07 | € 28,333 | € 32,545 |
Length of respiratory sequelae 6 years | € 2020 | 0.09 | 0.07 | € 23,512 | € 29,764 |
Length of respiratory sequelae 12 years | € 1841 | 0.10 | 0.07 | € 18,843 | € 27,125 |
Length of respiratory sequelae 24 years | € 1569 | 0.12 | 0.07 | € 13,574 | € 23,118 |
Length of respiratory sequelae: lifetime | € 1094 | 0.15 | 0.07 | € 7446 | € 16,112 |
Proportion of respiratory sequelae: +5% | € 1584 | 0.11 | 0.07 | € 14,054 | € 23,344 |
Proportion of respiratory sequelae: −5% | € 1801 | 0.10 | 0.07 | € 17,616 | € 26,529 |
Utility parameters | |||||
No utility decrement for RSV-H | € 1693 | 0.11 | 0.07 | € 15,947 | € 24,936 |
No utility decrement for allergy | € 1693 | 0.09 | 0.07 | € 19,414 | € 24,936 |
No utility decrement for asthma | € 1693 | 0.10 | 0.07 | € 17,224 | € 24,936 |
Cost parameters | |||||
Indirect costs associated with prophylaxis and hospitalization excluded | € 1552 | 0.11 | 0.07 | € 14,441 | € 22,867 |
Palivizumab cost: Proportions of 50 mg and 100 mg vial use equal to 0% and 100%, respectively | € 1751 | 0.11 | 0.07 | € 16,295 | € 25,804 |
Palivizumab cost: Proportion of 100 mg and 50 mg + 100 mg vial use, equals to 90% and 10%, respectively | € 1930 | 0.11 | 0.07 | € 17,954 | € 28,431 |
Palivizumab cost: Proportion of 100 mg and 50 mg + 100 mg vial use, equals to 40% and 60%, respectively | € 2821 | 0.11 | 0.07 | € 26,249 | € 41,566 |
Length of stay associated with RSV-H based on the pivotal trial (12.4 days pediatric ward, 38.1% ICU admission, 15.2 days ICU) [16] | € 1118 | 0.11 | 0.07 | € 10,402 | € 16,471 |
Indirect costs associated with prophylaxis, hospitalization, and respiratory sequelae excluded | € 1223 | 0.11 | 0.07 | € 11,374 | € 18,010 |
Costs associated with nosocomial infections excluded | € 1715 | 0.11 | 0.07 | € 15,954 | € 25,263 |
Exclude delayed surgeries pathway from decision tree | € 1855 | 0.11 | 0.07 | € 17,261 | € 27,332 |
Increased HCU in RSV-H: 0 years | € 2027 | 0.11 | 0.07 | € 18,861 | € 29,866 |
Increased HCU in RSV-H: 4 years | € 1860 | 0.21 | 0.17 | € 8882 | € 11,189 |