ECONOMIC-EVALUATION OF IMMUNOPROPHYLAXIS IN CHILDREN WITH RECURRENT EAR, NOSE AND THROAT INFECTIONS

This study compares the costs of immunoprophylaxis versus no immunopro phylaxis in children with recurrent ear, nose and throat (ENT) infecti ons (otitis media and rhinopharyngitis) using ribosomal immunotherapy ('Ribomunyl'). The per-patient cost of ribosomal immunotherapy (FF297) is offset by direct savings garnered through the prevention of many a cute infectious episodes. The net 6-month per-patient savings associat ed with immunoprophylaxis range from FF272 to FF1704, depending on the indication and the type of treatment-cost estimate. Saved healthcare resources include physician consultations and visits, laboratory tests , medicotechnical services (audiometric tests) and antibiotic therapy. Sensitivity analysis of efficacy and treatment-cost estimates enabled threshold ranges of incremental efficacy to be identified. Cost-equiv alence between the 2 treatment options was found to exist when the inc remental efficacy of immunoprophylaxis lay between 7.4 and 17.5% (recu rrent otitis media), and between 8.9 and 26.1% (recurrent rhinopharyng itis). Thus, even when clearly lower incremental efficacy rates than t hose reported in controlled clinical trials (approximately 40 to 60%) are assumed, ribosomal immunotherapy can still be expected to be cost effective. An analysis of the perspectives of the various payers in th e French healthcare system demonstrated that net savings occurred for all payers involved. However, social security insurance would gain mos t from an immunoprophylaxis programme. Based on the evidence presented here for France, physicians and payers should give increased attentio n to this treatment option.