Chetty Mersha, Costello Paul, Yarnoff Benjamin, Musci Robert, Ghemmouri Mehdi
Sanofi, 410 Thames Valley Park Drive, Reading, Berkshire, RG6 1PT, UK.
Evidera Inc., Wilmington, NC, USA.
Infect Dis Ther. 2025 Jul 23. doi: 10.1007/s40121-025-01194-3.
Respiratory syncytial virus (RSV) poses a significant health burden on infants, particularly during their first RSV season. Immunoprophylactic strategies, such as the administration of nirsevimab, a long-acting monoclonal antibody, have been developed to prevent RSV lower respiratory tract disease (LRTD). This study evaluated the public health and economic impact of nirsevimab or maternal immunisation (MI) compared with standard of practice (SoP) in the United Kingdom (UK).
A static decision-analytic model was employed to track the UK birth cohort during their first RSV season. The model incorporated UK-specific data on costs, epidemiology and healthcare resource utilisation. Three strategies were compared: historical SoP (pre-September 2024), universal immunisation with nirsevimab and MI. Outcomes measured included RSV-related primary care (PC) visits, accident and emergency (AE) visits, hospitalisations, intensive care unit (ICU) admissions and deaths. The model also considered the impact of recurrent wheezing episodes, all-cause LRTD hospitalisations and non-medically attended RSV-LRTDs.
Under the current SoP, RSV was estimated to cause 375,154 total health events and 24,360 RSV-LRTD hospitalisations (including ICU admissions) annually, resulting in an economic burden of £252 million. Universal immunisation with nirsevimab could prevent 208,691 total health events and 16,664 hospitalisations (including ICU admissions) and reduce costs by £105.7 million. MI showed a reduction in RSV-related outcomes but was less effective than nirsevimab, especially in preventing hospitalisations and ICU admissions or protecting infants born outside the RSV season.
Universal immunisation with nirsevimab for all infants during their first RSV season could significantly reduce both the health and economic burden of RSV in the UK. This strategy is more effective than MI, particularly in reducing severe RSV outcomes and protecting infants born outside the RSV season, thus offering substantial benefits across the infant population.
呼吸道合胞病毒（RSV）对婴儿构成重大健康负担，尤其是在他们的首个RSV流行季。已开发出免疫预防策略，如给予长效单克隆抗体尼塞韦单抗，以预防RSV下呼吸道疾病（LRTD）。本研究评估了在英国，与标准治疗方案（SoP）相比，尼塞韦单抗或母体免疫（MI）的公共卫生和经济影响。
采用静态决策分析模型来追踪英国出生队列在其首个RSV流行季的情况。该模型纳入了英国特定的成本、流行病学和医疗资源利用数据。比较了三种策略：历史SoP（2024年9月前）、尼塞韦单抗普遍免疫和MI。测量的结果包括与RSV相关的初级保健（PC）就诊、急诊（AE）就诊、住院、重症监护病房（ICU）收治和死亡。该模型还考虑了反复喘息发作、全因LRTD住院和未就医的RSV-LRTD的影响。
在当前的SoP下，估计RSV每年导致375,154起总体健康事件和24,360例RSV-LRTD住院（包括ICU收治），造成2.52亿英镑 的经济负担。尼塞韦单抗普遍免疫可预防208,691起总体健康事件和16,664例住院（包括ICU收治），并降低成本1.057亿英镑。MI显示与RSV相关的结果有所减少，但效果不如尼塞韦单抗，尤其是在预防住院和ICU收治或保护RSV流行季之外出生的婴儿方面。
在所有婴儿的首个RSV流行季对其进行尼塞韦单抗普遍免疫可显著减轻英国RSV的健康和经济负担。该策略比MI更有效，特别是在减少严重RSV结局和保护RSV流行季之外出生的婴儿方面，从而为全体婴儿群体带来巨大益处。
