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Access to palivizumab among children at high risk of respiratory syncytial virus complications in English hospitals

Zylbersztejn, A; Almossawi, O; Gudka, N; Tompsett, D; De Stavola, B; Standing, JF; Smyth, R; (2022) Access to palivizumab among children at high risk of respiratory syncytial virus complications in English hospitals. British Journal of Clinical Pharmacology , 88 (3) pp. 1246-1257. 10.1111/bcp.15069. Green open access

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Abstract

Objectives: Palivizumab is a monoclonal antibody which can prevent infection with respiratory syncytial virus (RSV). Due to its high cost, it is recommended for high-risk infants only. We aimed to determine the proportion of infants eligible for palivizumab treatment in England who receive at least one dose. / Methods: We used the Hospital Treatment Insights database containing hospital admission records linked to hospital pharmacy dispensing data for 43/153 hospitals in England. Infants born between 2010 and 2016 were considered eligible for palivizumab if their medical records indicated chronic lung disease (CLD), congenital heart disease (CHD), or severe immunodeficiency (SCID), and they met additional criteria based on gestational age at birth and age at start of the RSV season (beginning of October). We calculated the proportion of infants who received at least one dose of palivizumab in their first RSV season, and modelled the odds of treatment according to multiple child characteristics using logistic regression models. / Results: We identified 3,712 eligible children, of whom 2,479 (67%) had complete information on all risk factors. Palivizumab was prescribed to 832 of eligible children (34%). Being born at <30 weeks’ gestation, aged <6 months at the start of RSV season, and having two or more of CLD, CHD or SCID were associated with higher odds of treatment. / Conclusion: In England, palivizumab is not prescribed to the majority of children who are eligible to receive it. Doctors managing these infants may be unfamiliar with the eligibility criteria or constrained by other considerations, such as cost.

Type: Article
Title: Access to palivizumab among children at high risk of respiratory syncytial virus complications in English hospitals
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/bcp.15069
Publisher version: http://dx.doi.org/10.1111/bcp.15069
Language: English
Additional information: Copyright © 2021 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society. This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Keywords: Prescribing, Respiratory Medicine, Paediatrics, Neonatology
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept
URI: https://discovery-pp.ucl.ac.uk/id/eprint/10134204
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