RSV Protection for More Babies or Less?
Ever since Synagis (aka palivizumab) was brought to market by MedImmune, there has been debate over which babies should benefit from its RSV protection, and which should not. Synagis has been shown to reduce RSV related hospitalizations by 50%, it hasn’t been shown to reduce RSV related deaths, and while it is believed that RSV can cause longterm health problems like asthma, this is an area that is still under research. Synagis is expensive, with a cost of around $5,000-6,000 for 5 monthly treatments during RSV season [EDIT] for a newborn, and considerably more for older children [EDIT]. Looking strictly at cost-effectiveness, wider use can be hard to justify.
Respiratory syncytial virus (RSV) is an extremely contagious respiratory virus which causes cold-like symptoms. As many as 2/3 of babies are infected with RSV in their first year of life, and while symptoms are mild for most, RSV is the leading cause of hospitalization for infants and children in the US. Synagis is a synthetic antibody against RSV, which is given as a monthly injection during RSV season, which occurs some time between October and April in the US, depending on your geographic region and other factors.
Typically, Synagis is available for any baby who is born before 29 weeks, babies born before 32 weeks who are 6 months old at the start of RSV season, or any child under 2 with chronic lung disease or specific heart problems. Babies born between 32 and 35 weeks can receive the shot if they are less than 6 months old at the start of RSV season, and they have 2 additional risk factors, such as having school-aged siblings or going to daycare, exposure to tobacco smoke or low birth weight. There is a detailed table outlining qualifications for RSV prophylaxis at the Synagis website.
As the mother of a preemie who got RSV, and ended up in the hospital for 5 days, I’m a little torn on the issue of who should get Synagis. You see, we were unlucky, and Camden got RSV just 2 weeks after she got her first dose of Synagis. Her hospital stay cost about $4,600 (before insurance adjustments) which is less than the cost of a full season of Synagis. We did continue to get Synagis for the rest of the season, and somewhat ironically, we also qualified for a second year of Synagis because she was on oxygen so long after she got RSV (if a preemie is on oxygen within 6 months of the start of RSV season, they can qualify to receive the medication for their second winter).
Now, if insurance hadn’t covered the Synagis injections, I’m not sure what we would have done. Looking back with less emotion, I can see us opting not to do the shots if they hadn’t been covered, but at the time, I don’t think we would have wanted to take that chance. So, on one hand, I can see why parents of preemies and other babies want their child to receive Synagis, but for those looking at the issue from a strictly economic perspective, I can see why they argue against expanding coverage.
I’d love to hear from everyone out there about their own experiences with Synagis, RSV and insurance. Also, if you’re interested in learning more about RSV or Synagis, MedImmune has a very informative website you can visit here.
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November 14th, 2008 at 6:37 pm
My little dude received Synagis when he was an infant, but not when he was one. He got RSV from another baby in his daycare nursery. We spent 8 days in the hospital because of that. Because my little dude was a preemie, I’m sure the RSV hit his poor preemie respiratory system harder than others.
I understand the pros and cons of the treatment, but there is another angle parents should think about, especially when their child goes to daycare. Could your child get another child sick?