Rey-Ares Lucila, Averin Ahuva, Zuccarino Nadia, Vega Celina Guadalupe, Kutrieb Emily, Quinn Erin, Atwood Mark, Weycker Derek, Law Amy W
Pfizer SRL, Buenos Aires, Argentina.
Avalere Health, Boston, MA, USA.
Infect Dis Ther. 2024 Nov;13(11):2363-2376. doi: 10.1007/s40121-024-01055-5. Epub 2024 Oct 4.
Lower respiratory tract illness (LRTI) caused by respiratory syncytial virus (RSV) is common among young children in Argentina. Use of the currently available prophylactic agent is limited to children aged ≤ 2 years with selected high-risk conditions, and thus the majority of infants remain unprotected. We estimated the value-based price (VBP) of a novel RSVpreF vaccine for use among pregnant people for prevention of RSV-LRTI among infants during the first year of life.
Clinical outcomes and economic costs of RSV-LRTI during infancy and expected impact of RSVpreF vaccination during pregnancy were projected using a population-based Markov-type cohort model. Model results-estimated on the basis of gestational age at birth, disease/fatality rates, and mother's vaccination status-include total numbers of RSV-LRTI cases, RSV-LRTI-related deaths, and associated costs. Base case analyses (RSVpreF vs. no vaccine) were conducted from the healthcare system perspective. Probabilistic sensitivity analyses (PSA; 1000 replications) were also conducted. Willingness-to-pay (WTP) was $10,636 per quality-adjusted life-year (QALY; i.e., 1 × 2021 gross domestic product [GDP] per capita) in base case analyses and PSA. Costs are reported in USD, estimated on the basis of the June 22, 2023 exchange rate.
Use of RSVpreF among 342,110 pregnant persons provided protection to 330,079 infants at birth. In total, RSVpreF prevented 3915 RSV hospitalizations, 6399 RSV cases requiring emergency department care, 6182 RSV cases requiring a physician office visit, and 67 disease-related deaths. Direct costs were projected to be reduced by $5.0 million. With 2061 QALYs gained and vaccine administration cost of $1.4 million, the VBP of RSVpreF was estimated to be $74.46 per dose. In PSA, mean VBP was $75.02 (95% confidence interval 54.24-97.30).
RSVpreF among pregnant persons would significantly reduce the clinical and economic burden of RSV-LRTI among infants in Argentina and would be considered a cost-effective intervention up to a price of approximately $75.
呼吸道合胞病毒（RSV）引起的下呼吸道疾病（LRTI）在阿根廷幼儿中很常见。目前可用的预防剂仅限于年龄≤2岁且有特定高危状况的儿童，因此大多数婴儿仍未得到保护。我们估计了一种新型RSVpreF疫苗的基于价值的价格（VBP），该疫苗用于孕妇，以预防婴儿出生后第一年的RSV-LRTI。
使用基于人群的马尔可夫型队列模型预测婴儿期RSV-LRTI的临床结局和经济成本以及孕期接种RSVpreF疫苗的预期影响。基于出生时的胎龄、疾病/死亡率和母亲的疫苗接种状况估计的模型结果包括RSV-LRTI病例总数、与RSV-LRTI相关的死亡人数以及相关成本。从医疗保健系统的角度进行了基础病例分析（RSVpreF与未接种疫苗）。还进行了概率敏感性分析（PSA；1000次重复）。在基础病例分析和PSA中，支付意愿（WTP）为每质量调整生命年（QALY）10,636美元（即2021年人均国内生产总值[GDP]的1倍）。成本以美元报告，根据2023年6月22日的汇率估算。
342,110名孕妇使用RSVpreF为330,079名出生时的婴儿提供了保护。RSVpreF总共预防了3915例RSV住院、6399例需要急诊科护理的RSV病例、6182例需要医生门诊的RSV病例以及67例与疾病相关的死亡。预计直接成本将减少500万美元。获得2061个QALY且疫苗接种成本为140万美元，RSVpreF的VBP估计为每剂74.46美元。在PSA中，平均VBP为75.02美元（95%置信区间54.24-97.30）。
孕妇接种RSVpreF将显著减轻阿根廷婴儿RSV-LRTI的临床和经济负担，在价格约为75美元以下将被视为具有成本效益的干预措施。
