Managed Care - January 2009 - (Page CB-B3)

like structures that are the principal site of gas exchange in the lungs are not uniformly present until 36 weeks GA (Langston 1984). Preterm birth rates vary among racial, ethnic, and socioeconomic groups (Martin 2007). Of infants born preterm, approximately 75 percent are born 32 to 35 weeks GA (Figure 2), and about two thirds of these infants are likely to have two or more documented RSV risk factors (Figure 3). Although prematurity alone can significantly increase the risk for severe RSV disease, the presence of one or more other risk factors listed in the Table on page 4 may also increase susceptibility. Strong recent evidence cited in the literature (Table) supports that exposure to tobacco smoke, young chronological age, and crowded living conditions are linked to an increased risk of RSV disease. RSV is costly Actuarial cost analyses show that health care costs for infants 33 to 36 weeks GA who have a history of RSV hospitalization are substantially higher than FIGURE 2 32 to 35 weeks GA infants — a birth cohort at high risk for RSV • Of the 7.9% of U.S. infants born preterm (≤35 weeks GA) in 2005, approximately 75% were born 32 to 35 weeks GA.1,2 • Preterm birth rates vary among racial-ethnic and socioeconomic groups. Rates are highest for African-Americans and have increased by one third among whites and by 9% among Hispanics since 1990.1 Percentage of U.S. infants born preterm, 20051,2 Percent distribution of U.S. preterm births, 20051,2 28–31 weeks GA (15.8%) Total births (4,138,349) <28 weeks GA (9.6%) Preterm births (≤35 weeks GA) 7.9% 32–35 weeks GA (74.5%) GA=gestational age. 1 Martin JA, Hamilton BE, Sutton PD, et al. Division of Vital Statistics. Births: final data for 2005. Natl Vital Stat Rep. 2007;56:1–104. 2 Data on file, MedImmune, LLC. FIGURE 3 Infants born 32 to 35 weeks GA are likely to have two or more documented RSV risk factors All infants 7.9% of all infants are born preterm (≤35 weeks GA)1,2 ~75% of those preterm infants are 32 to 35 weeks GA1 Two thirds of these infants have two or more documented risk factors1 In a recent chart survey,* approximately two thirds of 32- to 35-week GA infants had two or more documented RSV risk factors.† * Survey included a review of 905 patient charts from pediatricians who manage patients ≤35 weeks GA.1 † Risk factors include school-aged siblings, daycare attendance, exposure to environmental air pollutants or tobacco smoke, severe neuromuscular disease, congenital abnormalities of the airways, low birthweight (<2500 g), crowded living conditions (≥ 4 in household), multiple births, and family history of asthma.1 1 Data on file, MedImmune, LLC. 2 Martin JA, Hamilton BE, Sutton PD, et al. Division of Vital Statistics. Births: final data for 2005. Natl Vital Stat Rep. 2007;56:1–104. 3

Table of Contents Feed for the Digital Edition of Managed Care - January 2009

Managed Care - January 2009 Editor's Memo Contents Legislation & Regulation News and Commentary Medication Management Compensation Monitor Health Care's Disruptive Innovations Q&A With Clayton Christensen 'Disruption' May Be Plans' Best Bet Avoid the PBM Rebate Trap HealthPartners Puts Diabetes on Notice Formulary Files Plan Watch Tomorrow's Medicine Ad Index Outlook Unmet Needs in the Management of Plaque Psoriasis Impact of RSV: Implications for Managed Care

Managed Care - January 2009

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