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To the Editor.
RSV-IGIV (RespiGam, MedImmune Inc, Gaithersburg, MD 20878, USA) was approved by the Food and Drug Administration in 1996, and recently endorsed by the American Academy of Pediatrics for prophylaxis against respiratory syncytial virus (RSV) infection in children under 24 months of age with history of bronchopulmonary dysplasia or premature birth (35 weeks or less). In the current environment of cost-consciousness, the drug's high cost, modest clinical efficacy, and potential for serious adverse reactions are critical concerns.
Based on a cost of $699.50 per 2.5-g RespiGam vial and $234.50 per intravenous infusion charges (“cost to the patient” as charged in a large, urban teaching hospital), we calculated that RSV-IGIV therapy at a dose of 750 mg/kg/infusion per month through the RSV season (November through April) for a 3.3-kg, 6.6-kg, and 10.0-kg infant would cost $5604, $9801, and $13 998, respectively. A cost analysis of RSV-IGIV therapy, based on RespiGam efficacy data from the PREVENT trial,1 is shown in the Table. …
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