The objectives were to compare actual respiratory syncytial virus (RSV) hospitalization rates and costs in a cohort of Inuit
infants to hypothetical palivizumab
prophylaxis strategies for infants of all gestational ages in the Eastern Canadian Arctic.
Incidence and costs of RSV hospitalization were collected for infants admitted to the Baffin Regional Hospital in 2002, before the initiation of palivizumab
. There was a comparison of the actual costs to the costs associated with 8 palivizumab
strategies stratified by age (<6 months, <1 year) and location (overall, town [Iqaluit], rural
communities). It was assumed that each category would receive universal palivizumab
prophylaxis resulting in a 78% decrease in RSV admissions. The net costs incurred, number needed to treat (NNT), and incremental costs per hospitalization avoided were calculated for each comparison.
There was a great variation in the rates and costs associated with RSV admissions between Iqaluit and the communities. For infants <1 year of age residing in Iqaluit, the mean admission cost was $3915, and palivizumab
prophylaxis had an NNT of 20.4 and cost of $162,551 per admission avoided. For rural
infants <6 months, the mean cost of admission was $23,030, and palivizumab
prophylaxis resulted in an NNT of 3.9 to 2.5 and cost savings of up to $8118 per admission avoided.
Due to the high rates and costs associated with RSV admissions, administration of palivizumab
communities in the Canadian Arctic to infants less than 6 months of age could result in net cost savings.