The cost and safety of multidose use of palivizumab vials.

Palivizumab is an antirespiratory syncytial virus humanized murine monoclonal antibody that has been shown to reduce the frequency of hospitalization rates of preterm infants infected with respiratory syncytial virus. The United States Food and Drug Administration has approved palivizumab for single-vial dosage; however, if multidose use of single-use vials is proven safe, significant cost savings for respiratory syncytial virus prophylaxis would result. A total of 446 palivizumab vials administered to patients during the respiratory syncytial virus seasons of 2004-2006 were examined for bacterial contamination. One single-use vial showed growth of multiple organisms, and all multidose-use vials were culture negative. The cost benefits of multidose palivizumab vials netted a potential average savings of $37 410 per year in this institution. This study suggests that multidose distribution is a possible solution for cost savings with no increased risk to patients. Secondary to the low incidence of complications, the safety of this practice will require a larger study.