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建立模型评估在西班牙,对所有新生儿和婴儿在其首个呼吸道合胞病毒季节用尼赛珠单抗进行普遍免疫接种与标准治疗相比的潜在临床和经济影响。

Modelling the potential clinical and economic impact of universal immunisation with nirsevimab versus standard of practice for protecting all neonates and infants in their first respiratory syncytial virus season in Spain.

机构信息

Department of Medical Specialties and Public Health, Rey Juan Carlos University, Madrid, Spain.

Public Health Directorate, Murcia Region, Spain.

出版信息

BMC Infect Dis. 2024 Sep 6;24(1):924. doi: 10.1186/s12879-024-09642-0.

Abstract

BACKGROUND

Respiratory syncytial virus (RSV) is associated with substantial morbidity among infants. This study modelled the potential public health and economic impact of nirsevimab, a long-acting monoclonal antibody, as an immunoprophylactic strategy for all infants in Spain in their first RSV season.

METHODS

A static decision-analytic model of the Spanish birth cohort during its first RSV season was developed to estimate the impact of nirsevimab on RSV-related health events and costs versus the standard of practice (SoP). Spain-specific costs and epidemiological data were used as model inputs. Modelled outcomes included RSV-related outpatient visits, emerging room (ER) visits, hospitalisations - including pediatric intensive care unit (PICU) admission, mechanical ventilation, and inpatient mortality.

RESULTS

Under the current SoP, RSV caused 151,741 primary care visits, 38,798 ER visits, 12,889 hospitalisations, 1,412 PICU admissions, and 16 deaths over a single season, representing a cost of €71.8 million from a healthcare payer perspective. Universal immunisation of all infants with nirsevimab was expected to prevent 97,157 primary care visits (64.0% reduction), 24,789 ER visits (63.9%), 8,185 hospitalisations (63.5%), 869 PICU admissions (61.5%), and 9 inpatient deaths (52.6%), saving €47.8 million (62.4%) in healthcare costs.

CONCLUSIONS

These results suggest that immunisation with nirsevimab of all infants experiencing their first RSV season in Spain is likely to prevent thousands of RSV-related health events and save considerable costs versus the current SoP.

摘要

背景

呼吸道合胞病毒(RSV)会导致婴儿出现大量发病。本研究建立了一个静态决策分析模型,对在其首个 RSV 季节中所有西班牙婴儿使用长效单克隆抗体 nirsevimab 作为免疫预防策略的潜在公共卫生和经济效益进行建模。

方法

为了估计 nirsevimab 对 RSV 相关健康事件和成本的影响,我们建立了一个针对西班牙首个人群的出生队列的静态决策分析模型,将其与标准实践(SoP)进行对比。该模型使用了西班牙特定的成本和流行病学数据作为模型输入。所建模的结果包括 RSV 相关的门诊就诊、急诊就诊、住院治疗——包括儿科重症监护病房(PICU)入院、机械通气和住院死亡率。

结果

在目前的 SoP 下,RSV 在单个季节内导致 151741 次初级保健就诊、38798 次急诊就诊、12889 次住院治疗、1412 次 PICU 入院和 16 例死亡,从医疗保健支付者的角度来看,成本为 7180 万欧元。对所有婴儿进行 nirsevimab 普遍免疫接种预计将预防 97157 次初级保健就诊(减少 64.0%)、24789 次急诊就诊(减少 63.9%)、8185 次住院治疗(减少 63.5%)、869 次 PICU 入院(减少 61.5%)和 9 例住院死亡(减少 52.6%),从而节省 4780 万欧元(减少 62.4%)的医疗保健成本。

结论

这些结果表明,在西班牙对所有经历首个 RSV 季节的婴儿进行 nirsevimab 免疫接种,与目前的 SoP 相比,可能会预防数千例 RSV 相关的健康事件并节省大量成本。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eee4/11378427/8a871cdab9bb/12879_2024_9642_Fig1_HTML.jpg

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