Cost-effectiveness analysis of prevention strategies for pediatric respiratory syncytial virus infection in Japan
Author(s)
Kazumasa Kamei, PhD1, Yu Funakoshi, MD, PhD, MPH2, Yasuhiro Kobayashi, MS3, Yoko Hirano, PhD1, Amy W. Law, MS, PharmD4;
1Pfizer Japan Inc., Japan Access & Value, Tokyo, Japan, 2Pfizer Japan Inc., Chief Medical Affairs Office RWE Platform, Tokyo, Japan, 3Pfizer Japan Inc., Medical Japan, Vaccine Medical Affairs, Tokyo, Japan, 4Pfizer Inc., Global Access & Value, New York, NY, USA
1Pfizer Japan Inc., Japan Access & Value, Tokyo, Japan, 2Pfizer Japan Inc., Chief Medical Affairs Office RWE Platform, Tokyo, Japan, 3Pfizer Japan Inc., Medical Japan, Vaccine Medical Affairs, Tokyo, Japan, 4Pfizer Inc., Global Access & Value, New York, NY, USA
Presentation Documents
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