We appreciate the interest expressed by employees from MedImmune and AstraZeneca (McLaurin and Ambrose) concerning our commentary regarding the minimal benefit and the high cost of respiratory syncytial virus (RSV) immunoprophylaxis, and we submit the following responses to issues they raised.

McLaurin and Ambrose suggest a mean hospital charge of $8530 for 1 RSV hospitalization is not accurate and cite a charge for RSV hospitalization for children at high risk <13 months of age as$20 160 to \$39 399. The reference for their figures is an article authored by MedImmune employees, and they exceed charges reported in other studies. A higher mean charge for an RSV hospitalization will drive a cost analysis in favor of immunoprophylaxis. As noted in our commentary, cost figures proposed by the manufacturer consistently are higher and more favorable to use of prophylaxis than figures used in analyses conducted by independent researchers. Also,...