In reply

摘要

We welcome the opportunity to reply to Mahadevia and Malinoski's comments on our article, which correctly highlight the challenges of performing cost-effectiveness analyses (CEA) when complete data for components of the model are not available in the literature.They state that our model1 undervalues the benefit of avoiding asthma following respiratory syncytial virus (RSV) infection. First, as noted in our article,1 a causal relationship between RSV infection and asthma has not been established. Second, factors that increase susceptibility to RSV infection likely also confer increased risk of asthma later. Incorporating future risk of asthma in a CEA model of RSV prophylaxis using palivizumab is novel and has not been included in prior CEA studies. Despite including future risk of asthma, which favors the cost-effectiveness of RSV prophylaxis, our analysis did not find palivizumab to be cost-effective.