Anyone could understand why a worried parent would want a drug that might alleviate the suffering of an infant and reduce the risk of serious consequences from a disease. But at midwinter the peak of the RSV season the debate among pediatricians about Synagis is also providing a window into larger concerns over whether America s health care system is in a position to draw the line between proper and improper use of all the expensive new drugs being developed. For most children, RSV behaves little worse than a cold. But children born prematurely or with chronic lung disease are more vulnerable. Of those, studies have estimated that 500 to 4,500 could die.
Society has to decide how much it is worth to prevent a day in the hospital.
But Dr. Brian Carter, a neonatologist and associate professor at Vanderbilt University, worries that efforts to restrict the drug because it is so expensive threatens to create a two-tier system of health care. Executives at MedImmune say the treatment is well worth the price. They say that hospitalizing one baby infected with RSV is often far more costly than the price for a series of Synagis shots. Health insurers and hospitals asked to pay for the treatment, they argue, should consider what has already been spent on the baby s health care. Society or the payer have already spent, for some of these babies, tens of thousands of dollars to keep them alive.