Cost-effectiveness analysis of prevention strategies for pediatric respiratory syncytial virus infection in Japan
Moderator
Kazumasa Kamei, PhD, Pfizer Japan Inc., Shibuya-ku, Japan
Speakers
Yu Funakoshi; Kobayashi Yasuhiro; Yoko Hirano, Japan Access & Value, Pfizer Japan Inc, Tokyo, Japan; Amy Law, MS, PharmD, Pfizer, New York, NY, United States
OBJECTIVES: Respiratory syncytial virus (RSV) is a major cause of respiratory illness in children. The standard of care (SoC), a monoclonal antibody (mAb), palivizumab, was licensed for the prevention of RSV infection for infants with risk and premature infants born ≤35 weeks gestational age (wGA). In 2024, another mAb, nirsevimab, for infants and bivalent RSV prefusion F protein-based (RSVpreF) vaccine for pregnant women are also available. This study assessed the cost-effectiveness of various prevention strategies for pediatric RSV infection in Japanese setting.
METHODS: A Markov model estimated the clinical and economic outcomes due to medically attended RSV infections from birth through 11 months. Incremental cost-effectiveness ratios (ICERs) and quality-adjusted life years (QALYs) were evaluated from a healthcare payer's perspective. RSVpreF vaccine was assumed to be effective for infants born ≥32 wGA to vaccinated mothers. In the combined strategy, RSVpreF vaccine was administrated to pregnant women, followed by the supplementary administration of nirsevimab to infants with risk, infants born ≤31 wGA and infants born 32-35 wGA unprotected by RSVpreF vaccine.
RESULTS: With SoC, 39,193 medically attended RSV cases (17,464 hospitalizations, 8,078 emergency department visits, 13,650 outpatient visits) and 21 deaths were estimated, with a corresponding total cost of 38.2 billion yen. Nirsevimab usage restricted to the same population (current reimbursement scope) was a dominant strategy (more effective and less costly) over SoC, but majority of infants remain unprotected against RSV infection. A year-round RSVpreF vaccine with the supplementary administration of nirsevimab prevented a total of 12,106 medically attended RSV cases (6,944 hospitalizations, 1,780 emergency department visits, 3,381 outpatient visits) and 8 deaths against SoC. The strategy was also dominant against SoC, but at a much higher QALY gained and more infants protected.
CONCLUSIONS: A year-round RSVpreF vaccine with nirsevimab could be one of the most optimal prophylaxis strategies for pediatric RSV infection in Japan.
METHODS: A Markov model estimated the clinical and economic outcomes due to medically attended RSV infections from birth through 11 months. Incremental cost-effectiveness ratios (ICERs) and quality-adjusted life years (QALYs) were evaluated from a healthcare payer's perspective. RSVpreF vaccine was assumed to be effective for infants born ≥32 wGA to vaccinated mothers. In the combined strategy, RSVpreF vaccine was administrated to pregnant women, followed by the supplementary administration of nirsevimab to infants with risk, infants born ≤31 wGA and infants born 32-35 wGA unprotected by RSVpreF vaccine.
RESULTS: With SoC, 39,193 medically attended RSV cases (17,464 hospitalizations, 8,078 emergency department visits, 13,650 outpatient visits) and 21 deaths were estimated, with a corresponding total cost of 38.2 billion yen. Nirsevimab usage restricted to the same population (current reimbursement scope) was a dominant strategy (more effective and less costly) over SoC, but majority of infants remain unprotected against RSV infection. A year-round RSVpreF vaccine with the supplementary administration of nirsevimab prevented a total of 12,106 medically attended RSV cases (6,944 hospitalizations, 1,780 emergency department visits, 3,381 outpatient visits) and 8 deaths against SoC. The strategy was also dominant against SoC, but at a much higher QALY gained and more infants protected.
CONCLUSIONS: A year-round RSVpreF vaccine with nirsevimab could be one of the most optimal prophylaxis strategies for pediatric RSV infection in Japan.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE159
Topic
Economic Evaluation
Disease
SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory), STA: Vaccines