What is known: • RSV infection has a high burden of disease in preterm infants leading to hospitalisations and recurrent wheezing during the first year of life. • Due to high costs , the cost-efffectiveness of RSV prophylaxis is the subject of debate, a targeted prophylaxis strategy could positively impact the cost-effectiveness analyses in a time of health care budget constraints.

What is new: • Our results show that targeted RSV prophylaxis is not cost-effective, but it can become cost-effective if a biosimilar palivizumab becomes available at 40% of the cost of current RSV prophylaxis.