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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

Amanda M. Kong
1   Watson Health Value Based Care, Truven Health Analytics, an IBM Company, Cambridge, Massachusetts
,
Leonard R. Krilov
2   Pediatric Infectious Diseases, Children's Medical Center, NYU Winthrop, Mineola, New York
,
Jaime Fergie
3   Department of Pediatric Infectious Disease, Driscoll Children's Hospital, Corpus Christi, Texas
,
Mitchell Goldstein
4   Division of Neonatal Medicine, Loma Linda University Children's Hospital, Linda Loma, California
,
David Diakun
1   Watson Health Value Based Care, Truven Health Analytics, an IBM Company, Cambridge, Massachusetts
,
Sally W. Wade
5   Wade Outcomes Research and Consulting, Salt Lake City, Utah
,
Melissa Pavilack
6   Health Economics and Outcomes Research, AstraZeneca, Gaithersburg, Maryland
,
Kimmie K. McLaurin
6   Health Economics and Outcomes Research, AstraZeneca, Gaithersburg, Maryland
› Author Affiliations
Further Information

Publication History

06 June 2017

26 July 2017

Publication Date:
07 September 2017 (online)

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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

Note

This work was presented as a poster titled “Impact of 2014 American Academy of Pediatrics Guidance for RSV Immunoprophylaxis” at AMCP Nexus 2016, National Harbor, MD, October 3–6, 2016, and was presented as a platform presentation titled “Impact of 2014 American Academy of Pediatrics Policy for Respiratory Syncytial Virus (RSV) Immunoprophylaxis” at the Pediatric Academic Societies (PAS) 2017 Meeting, San Francisco, CA, May 6–9, 2017.


Supplementary Material

 

  • References

  • 1 Stockman LJ, Curns AT, Anderson LJ, Fischer-Langley G. Respiratory syncytial virus-associated hospitalizations among infants and young children in the United States, 1997-2006. Pediatr Infect Dis J 2012; 31 (01) 5-9
    CrossrefPubMedSearch in Google Scholar
  • 2 Nair H, Nokes DJ, Gessner BD. , et al. Global burden of acute lower respiratory infections due to respiratory syncytial virus in young children: a systematic review and meta-analysis. Lancet 2010; 375 (9725): 1545-1555
    CrossrefPubMedSearch in Google Scholar
  • 3 Boyce TG, Mellen BG, Mitchel Jr EF, Wright PF, Griffin MR. Rates of hospitalization for respiratory syncytial virus infection among children in Medicaid. J Pediatr 2000; 137 (06) 865-870
    CrossrefPubMedSearch in Google Scholar
  • 4 Stevens TP, Sinkin RA, Hall CB, Maniscalco WM, McConnochie KM. Respiratory syncytial virus and premature infants born at 32 weeks' gestation or earlier: hospitalization and economic implications of prophylaxis. Arch Pediatr Adolesc Med 2000; 154 (01) 55-61
    PubMedSearch in Google Scholar
  • 5 Ambrose CS, Anderson EJ, Simões EA. , et al. Respiratory syncytial virus disease in preterm infants in the U.S. born at 32-35 weeks gestation not receiving immunoprophylaxis. Pediatr Infect Dis J 2014; 33 (06) 576-582
    CrossrefPubMedSearch in Google Scholar
  • 6 Winterstein AG, Knox CA, Kubilis P, Hampp C. Appropriateness of age thresholds for respiratory syncytial virus immunoprophylaxis in moderate-preterm infants: a cohort study. JAMA Pediatr 2013; 167 (12) 1118-1124
    CrossrefPubMedSearch in Google Scholar
  • 7 Mauskopf J, Margulis AV, Samuel M, Lohr KN. Respiratory syncytial virus hospitalizations in healthy preterm infants: systemic review. Pediatr Infect Dis J 2016; 35 (07) e229-e238
    CrossrefPubMedSearch in Google Scholar
  • 8 Synagis® (Palivizumab) [Prescribing Information]. Gaithersburg, MD: AstraZeneca; 2014
    Search in Google Scholar
  • 9 American Academy of Pediatrics Committee on Infectious Diseases; American Academy of Pediatrics Bronchiolitis Guidelines Committee. Updated guidance for palivizumab prophylaxis among infants and young children at increased risk of hospitalization for respiratory syncytial virus infection. Pediatrics 2014; 134 (02) 415-420
    CrossrefPubMedSearch in Google Scholar
  • 10 Anderson EJ, Krilov LR, DeVincenzo JP. , et al. SENTINEL1: an observational study of respiratory syncytial virus hospitalizations among U.S. infants born at 29 to 35 weeks' gestational age not receiving immunoprophylaxis. Am J Perinatol 2017; 34 (01) 51-61
    Thieme ConnectPubMedSearch in Google Scholar
  • 11 Rajah B, Sánchez PJ, Garcia-Maurino C, Leber A, Ramilo O, Mejias A. Impact of the updated guidance for palivizumab prophylaxis against respiratory syncytial virus infection: a single center experience. J Pediatr 2017; 181: 183-188.e1
    CrossrefPubMedSearch in Google Scholar
  • 12 Blake SM, Tanaka D, Bendz LM, Staebler S, Brandon D. Evaluation of the financial and health burden of infants at risk for respiratory syncytial virus. Adv Neonatal Care 2017; 17 (04) 292-298
    CrossrefPubMedSearch in Google Scholar
  • 13 Grindeland CJ, Mauriello CT, Leedahl DD, Richter LM, Meyer AC. Association between updated guideline-based palivizumab administration and hospitalizations for respiratory syncytial virus infections. Pediatr Infect Dis J 2016; 35 (07) 728-732
    CrossrefPubMedSearch in Google Scholar
  • 14 Truven Health Analytics. Marketscan studies: abbreviated bibliography. Available at: https://truvenhealth.com/Portals/0/Assets/Life-Sciences/Bibliographies/2016-Truven-Health-MarketScan-Bibliography.pdf . Accessed March 29, 2017
    PubMed
  • 15 Palmer L, Hall CB, Katkin JP. , et al. Respiratory outcomes, utilization and costs 12 months following a respiratory syncytial virus diagnosis among commercially insured late-preterm infants. Curr Med Res Opin 2011; 27 (02) 403-412
    CrossrefPubMedSearch in Google Scholar
  • 16 Palmer L, Hall CB, Katkin JP. , et al. Healthcare costs within a year of respiratory syncytial virus among Medicaid infants. Pediatr Pulmonol 2010; 45 (08) 772-781
    CrossrefPubMedSearch in Google Scholar
  • 17 Krilov LR, Masaquel AS, Weiner LB, Smith DM, Wade SW, Mahadevia PJ. Partial palivizumab prophylaxis and increased risk of hospitalization due to respiratory syncytial virus in a Medicaid population: a retrospective cohort analysis. BMC Pediatr 2014; 14: 261
    CrossrefPubMedSearch in Google Scholar
  • 18 McLaurin KK, Farr AM, Wade SW, Diakun DR, Stewart DL. Respiratory syncytial virus hospitalization outcomes and costs of full-term and preterm infants. J Perinatol 2016; 36 (11) 990-996
    CrossrefPubMedSearch in Google Scholar
  • 19 Haynes AK, Prill MM, Iwane MK, Gerber SI. ; Centers for Disease Control and Prevention (CDC). Respiratory syncytial virus–United States, July 2012-June 2014. MMWR Morb Mortal Wkly Rep 2014; 63 (48) 1133-1136
    PubMedSearch in Google Scholar
  • 20 Makari D, Staat MA, Henrickson KJ, Wu X, Ambrose CS. The underrecognized burden of respiratory syncytial virus among infants presenting to US emergency departments. Clin Pediatr (Phila) 2015; 54 (06) 594-597
    CrossrefPubMedSearch in Google Scholar
  • 21 The IMpact-RSV Study Group. Palivizumab, a humanized respiratory syncytial virus monoclonal antibody, reduces hospitalization from respiratory syncytial virus infection in high-risk infants. Pediatrics 1998; 102 (3, Pt 1): 531-537
    CrossrefPubMedSearch in Google Scholar
  • 22 Blanken MO, Rovers MM, Molenaar JM. , et al; Dutch RSV Neonatal Network. Respiratory syncytial virus and recurrent wheeze in healthy preterm infants. N Engl J Med 2013; 368 (19) 1791-1799
    CrossrefPubMedSearch in Google Scholar
  • 23 Anderson EJ, Carosone-Link P, Yogev R, Yi J, Simões EAF. Effectiveness of palivizumab in high-risk infants and children: a propensity score weighted regression analysis. Pediatr Infect Dis J 2017; 36 (08) 699-704
    CrossrefPubMedSearch in Google Scholar
  • 24 Hall CB, Weinberg GA, Blumkin AK. , et al. Respiratory syncytial virus-associated hospitalizations among children less than 24 months of age. Pediatrics 2013; 132 (02) e341-e348
    CrossrefPubMedSearch in Google Scholar
  • 25 Simões EA, Anderson EJ, Wu X, Ambrose CS. Effects of chronologic age and young child exposure on respiratory syncytial virus disease among US preterm infants born at 32 to 35 weeks gestation. PLoS One 2016; 11 (11) e0166226
    CrossrefPubMedSearch in Google Scholar
  • 26 Yogev R, Krilov LR, Fergie JE, Weiner LB. Re-evaluating the new Committee on Infectious Diseases recommendations for palivizumab use in premature infants. Pediatr Infect Dis J 2015; 34 (09) 958-960
    CrossrefPubMedSearch in Google Scholar
  • 27 Goldstein M, Merritt TA, Phillips R. , et al. National Perinatal Association 2015 respiratory syncytial virus (RSV) prevention guideline. Neonatology Today 2014; 9 (11) 1-11
    PubMedSearch in Google Scholar
  • 28 Franklin JA, Anderson EJ, Wu X, Ambrose CS, Simões EA. Insurance status and the risk of severe respiratory syncytial virus disease in United States preterm infants born at 32–35 weeks gestational age. Open Forum Infect Dis 2016; 3 (03) ofw163
    CrossrefPubMedSearch in Google Scholar
  • 29 Greenbaum AH, Chen J, Reed C. , et al. Hospitalizations for severe lower respiratory tract infections. Pediatrics 2014; 134 (03) 546-554
    CrossrefPubMedSearch in Google Scholar
  • 30 Ambrose CS. Statistical power to detect an association between guideline-based palivizumab administration and hospitalizations for respiratory syncytial virus infections. Pediatr Infect Dis J 2017; 36 (03) 348
    PubMedSearch in Google Scholar
  • 31 Farber HJ. Impact of the 2014 American Academy of Pediatrics guidance on respiratory syncytial virus and bronchiolitis hospitalization rates for infants born prematurely. J Pediatr 2017; 185: 250
    CrossrefPubMedSearch in Google Scholar
  • 32 Texas Medicaid/CHIP Vendor Drug Program Fee-For-Service Medicaid Synagis® Request Form, 2014–2015 Season
    PubMed
  • 33 McLaurin KK, Chatterjee A, Makari D. Modeling the potential impact of the 2014 American Academy of Pediatrics respiratory syncytial virus prophylaxis guidance on preterm infant RSV outcomes. Infect Dis Ther 2015; 4 (04) 503-511
    CrossrefPubMedSearch in Google Scholar
  • 34 Hamilton BE, Martin JA, Osterman MJ, Curtin SC, Matthews TJ. Births: final data for 2014. Natl Vital Stat Rep 2015; 64 (12) 1-64
    PubMedSearch in Google Scholar