We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
The Pediatric Forum |

Cost-effectiveness of Respiratory Syncytial Virus Prophylaxis With Palivizumab—Reply

Melony E. S. Sorbero, PhD, MS, MPH; Nahed O. ElHassan, MD, MPH; Caroline B. Hall, MD; Timothy P. Stevens, MD, MPH; Andrew W. Dick, PhD
Arch Pediatr Adolesc Med. 2007;161(5):519-520. doi:10.1001/archpedi.161.5.520-a.
Text Size: A A A
Published online


In reply

We welcome the opportunity to reply to Mahadevia and Malinoski's comments on our article, which correctly highlight the challenges of performing cost-effectiveness analyses (CEA) when complete data for components of the model are not available in the literature.

They state that our model1 undervalues the benefit of avoiding asthma following respiratory syncytial virus (RSV) infection. First, as noted in our article,1 a causal relationship between RSV infection and asthma has not been established. Second, factors that increase susceptibility to RSV infection likely also confer increased risk of asthma later. Incorporating future risk of asthma in a CEA model of RSV prophylaxis using palivizumab is novel and has not been included in prior CEA studies. Despite including future risk of asthma, which favors the cost-effectiveness of RSV prophylaxis, our analysis did not find palivizumab to be cost-effective. Third, few studies of the health status of children with asthma include instruments that yield appropriate data for inclusion in cost-effectiveness analyses; we used the best data available at that time of our analysis. In a more recent report, adult assessment of quality of life for children with at least mild or moderate asthma found an average quality of life of 0.83.2 This value is within the range included in our sensitivity analyses. Our sensitivity analyses showed that the value for quality of life with asthma must be no greater than 0.80 for RSV prophylaxis to be considered cost-effective for any of the groups in our analyses.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





May 1, 2007
Parthiv J. Mahadevia, MD, MPH; Frank J. Malinoski, MD, PhD
Arch Pediatr Adolesc Med. 2007;161(5):519-520. doi:10.1001/archpedi.161.5.519.
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

3 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles