The 2014–2015 National Impact of the 2014 American Academy of Pediatrics Guidance for Respiratory Syncytial Virus Immunoprophylaxis on Preterm Infants Born in the United States

Amanda M. Kong; Leonard R. Krilov; Jaime Fergie; Mitchell Goldstein; David Diakun; Sally W. Wade; Melissa Pavilack; Kimmie K. McLaurin

doi:10.1055/s-0037-1606352

American Journal of Perinatology, Inhaltsverzeichnis

CC-BY-NC-ND 4.0 · Am J Perinatol 2018; 35(02): 192-200
DOI: 10.1055/s-0037-1606352

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The 2014–2015 National Impact of the 2014 American Academy of Pediatrics Guidance for Respiratory Syncytial Virus Immunoprophylaxis on Preterm Infants Born in the United States

Authors

Amanda M. Kong

¹Watson Health Value Based Care, Truven Health Analytics, an IBM Company, Cambridge, Massachusetts
Leonard R. Krilov

²Pediatric Infectious Diseases, Children's Medical Center, NYU Winthrop, Mineola, New York
Jaime Fergie

³Department of Pediatric Infectious Disease, Driscoll Children's Hospital, Corpus Christi, Texas
Mitchell Goldstein

⁴Division of Neonatal Medicine, Loma Linda University Children's Hospital, Linda Loma, California
David Diakun

¹Watson Health Value Based Care, Truven Health Analytics, an IBM Company, Cambridge, Massachusetts
Sally W. Wade

⁵Wade Outcomes Research and Consulting, Salt Lake City, Utah
Melissa Pavilack

⁶Health Economics and Outcomes Research, AstraZeneca, Gaithersburg, Maryland
Kimmie K. McLaurin

⁶Health Economics and Outcomes Research, AstraZeneca, Gaithersburg, Maryland

Abstract

Objective This article aims to compare respiratory syncytial virus (RSV) immunoprophylaxis (IP) use and RSV hospitalization rates (RSVH) in preterm and full-term infants without chronic lung disease of prematurity or congenital heart disease before and after the recommendation against RSV IP use in preterm infants born at 29 to 34 weeks' gestational age (wGA).

Study Design Infants in commercial and Medicaid claims databases were followed from birth through first year to assess RSV IP and RSVH, as a function of infant's age and wGA. RSV IP was based on pharmacy or outpatient medical claims for palivizumab. RSVH was based on inpatient medical claims with a diagnosis of RSV.

Results Commercial and Medicaid infants 29 to 34 wGA represented 2.9 to 3.5% of all births. RSV IP use in infants 29 to 34 wGA decreased 62 to 95% (p < 0.01) in the 2014–2015 season relative to the 2013–2014 season. Compared with the 2013–2014 season, RSVH increased by 2.7-fold (p = 0.02) and 1.4-fold (p = 0.03) for infants aged <3 months and 29 to 34 wGA in the 2014–2015 season with commercial and Medicaid insurance, respectively. In the 2014–2015 season, RSVH for infants 29 to 34 wGA were two to seven times higher than full-term infants without high-risk conditions.

Conclusion Following the 2014 RSV IP guidance change, RSV IP use declined and RSVH increased among infants born at 29 to 34 wGA and aged <3 months.

Keywords

respiratory syncytial virus - immunoprophylaxis - hospitalization rates - palivizumab

Volltext

Referenzen

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