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Access to palivizumab among children at high risk of respiratory syncytial virus complications in English hospitals
Author(s) -
Zylbersztejn Ania,
Almossawi Ofran,
Gudka Nikesh,
Tompsett Daniel,
De Stavola Bianca,
Standing Joseph F.,
Smyth Rosalind,
Hardelid Pia
Publication year - 2022
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.15069
Subject(s) - palivizumab , medicine , pediatrics , gestational age , pharmacy , odds ratio , respiratory system , pregnancy , family medicine , biology , genetics
Aims Palivizumab is a monoclonal antibody which can prevent infection with respiratory syncytial virus (RSV). Due to its high cost, it is recommended for high‐risk infants only. We aimed to determine the proportion of infants eligible for palivizumab treatment in England who receive at least one dose. Methods We used the Hospital Treatment Insights database, which contains hospital admission records linked to hospital pharmacy dispensing data for 43 out of 153 hospitals in England. Infants born between 2010 and 2016 were considered eligible for palivizumab if their medical records indicated chronic lung disease (CLD), congenital heart disease (CHD) or severe immunodeficiency (SCID), and they met additional criteria based on gestational age at birth and age at start of the RSV season (beginning of October). We calculated the proportion of infants who received at least one dose of palivizumab in their first RSV season, and modelled the odds of treatment according to multiple child characteristics using logistic regression models. Results We identified 3712 eligible children, of whom 2479 (67%) had complete information on all risk factors. Palivizumab was prescribed to 832 of eligible children (34%). Being born at <30 weeks' gestation, aged <6 months at the start of RSV season, and having two or more of CLD, CHD or SCID were associated with higher odds of treatment. Conclusion In England, palivizumab is not prescribed to the majority of children who are eligible to receive it. Doctors managing these infants may be unfamiliar with the eligibility criteria or constrained by other considerations, such as cost.