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Optimizing the drug use process to enhance cost-effectiveness of palivizumab therapy in neonates
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
2012 (English)Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
Abstract [en]

Introduction: There is a high risk of developing lower respiratory tract disease caused by respiratory syncytial virus (RSV) among premature children and children with lung or heart diseases.  For this high risk population, an RSV-infection may lead to life threatening conditions. Synagis® (palivizumab) is a monoclonal antibody given as prophylaxis during the RSV-season. The high cost highlights the importance of optimal drug use process. Aim: The purpose of this study was to assess the cost-effectiveness of palivizumab by investigate if ideal body weight (IBW), fixed dose regimen, body surface area (BSA) or abbreviated three or four monthly doses can be used instead of body weight, and calculated potential cost savings including  new ways of reducing disposal of palivizumab. Materials and Methods: Qlik View was used to extract electronic medical records kept in Karolinska Data Warehouse (Karda) since 2008 regarding the use and dosing strategy of palivizumab at Astrid Lindgren Children’s Hospital. This study validated the Karda dataset. Results: A total of 207 patients and 444 administrations were included. Dosing by fixed dose regimen gives practical advantages and gives a standardized method leading to minimized product wastage. Dosing by BSA reduces the costs and amount most and also the pain associated with administration. IBW gives no potential cost saving given the current 15 mg/kg, but may reduce the variability. There is limited knowledge about abbreviated dose regimen but there is potential cost savings. Conclusions: There is a great need of clinical studies in the neonatal population to ensure a sufficient concentration is achieved with lower or fewer doses in order to increase the cost-effectiveness.  The recommendations for this year is to use fixed dosing, prolonging the shelf-life and plan for a pharmacokinetic study to evaluate the effect of these dosing strategies.

Place, publisher, year, edition, pages
2012. , 34 p.
Keyword [en]
National Category
Clinical Medicine
URN: urn:nbn:se:uu:diva-192986OAI: oai:DiVA.org:uu-192986DiVA: diva2:600980
External cooperation
Karolinska Universitetssjukhuset
Subject / course
Educational program
Master of Science Programme in Pharmacy
Available from: 2013-01-31 Created: 2013-01-28 Last updated: 2013-01-31Bibliographically approved

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