Zeevat Florian, van der Pol Simon, Kieffer Alexia, Postma Maarten J, Boersma Cornelis
Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Health-Ecore, Zeist, The Netherlands.
Pharmacoeconomics. 2025 May;43(5):569-582. doi: 10.1007/s40273-025-01469-0. Epub 2025 Feb 20.
This study aimed to assess the cost effectiveness of nirsevimab, a recently authorized monoclonal antibody (mAb) for the prevention of lower respiratory tract disease (LRTD) caused by respiratory syncytial virus (RSV), in comparison with the standard practice involving palivizumab for high-risk infants during their first RSV season in the Netherlands.
A static cost-effectiveness model was populated for the Netherlands to evaluate different immunization strategies for nirsevimab over a single RSV season from a societal perspective. The model considered the most recently published RSV incidence data (average incidence from 2006 to2018), costs (adjusted to the 2023 price year), and associated health effects. Extensive scenario analyses were conducted to explore various strategies, and sensitivity analysis was performed to assess the model's robustness.
In the base-case scenario, all-infant protection-a strategy of in-season with catch-up immunization for all infants-nirsevimab has the potential to prevent numerous RSV-related cases, including 2333 hospitalizations and 150 intensive-care admissions, in the overall population compared with the standard of care. Nirsevimab appears to be cost effective under this strategy with an economically justifiable acquisition price for nirsevimab of €220 at a willingness-to-pay threshold of €50,000 per quality-adjusted life-year. Sensitivity analyses indicate a 52% probability that nirsevimab is cost effective at this threshold. Comparison of different vaccination strategies revealed that the all-infant protection approach was the one that prevented the higher number of cases.
This study indicates that universal infant immunization with nirsevimab has the potential to be cost effective and significantly reduces the burden of RSV among Dutch infants. These findings underscore the importance of implementing effective protective measures against RSV-LRTD, reducing the pressure on the healthcare system during the RSV season.
本研究旨在评估nirsevimab（一种最近获批用于预防呼吸道合胞病毒（RSV）引起的下呼吸道疾病（LRTD）的单克隆抗体）的成本效益，与荷兰高危婴儿在首个RSV流行季使用帕利珠单抗的标准做法进行比较。
为荷兰建立了一个静态成本效益模型，从社会角度评估nirsevimab在单个RSV流行季的不同免疫策略。该模型考虑了最新公布的RSV发病率数据（2006年至2018年的平均发病率）、成本（调整至2023年价格年度）以及相关的健康影响。进行了广泛的情景分析以探索各种策略，并进行了敏感性分析以评估模型的稳健性。
在基础情景中，全婴儿保护策略（即对所有婴儿在流行季进行补种免疫）下，与标准治疗相比，nirsevimab有可能在总体人群中预防大量RSV相关病例，包括2333例住院和150例重症监护入院。在该策略下，nirsevimab似乎具有成本效益，在每质量调整生命年支付意愿阈值为50,000欧元时，nirsevimab的可接受购置价格为220欧元在经济上是合理的。敏感性分析表明，在此阈值下nirsevimab具有成本效益的概率为52%。不同疫苗接种策略的比较显示，全婴儿保护方法预防的病例数更多。
本研究表明，对婴儿普遍接种nirsevimab有可能具有成本效益，并显著减轻荷兰婴儿中RSV的负担。这些发现强调了实施针对RSV-LRTD的有效保护措施的重要性，减轻RSV流行季期间医疗系统的压力。
