Nirsevimab for RSV Prevention in Hong Kong Infants: A Cost-Effectiveness Analysis
Moderator
YINGCHENG WANG, The Chinese University of Hong Kong, Hong Kong, China
Speakers
Mingjun Rui, The Chinese University of Hong Kong, Hong Kong, China; Joyce You, PharmD, The Chinese University of Hong Kong, Shatin, China
OBJECTIVES: Respiratory Syncytial Virus (RSV) is a leading cause of lower respiratory tract infections (LRTI) in infants. Nirsevimab, a long-acting monoclonal antibody, provides broad protection and demonstrates high efficacy. This study evaluated the cost-effectiveness of various nirsevimab immunization strategies from the Hong Kong societal perspective.
METHODS: A Markov model with monthly cycle was developed to simulate the one-year outcomes of the 2024 birth cohort in Hong Kong (36,106 newborns). Four immunization strategies were evaluated in the model: (1) No intervention; (2) single-dose of nirsevimab at birth throughout the year (year- round); (3) single-dose nirsevimab at birth for infants born during the RSV season and at the start of the season for those born outside season (catch-up); (4) single-dose of nirsevimab to infants born during RSV season (seasonal). Model inputs were retrieved from public data and literature. Primary outcomes included RSV-LRTI related events, direct and indirect costs, quality-adjusted life year (QALY) loss, and incremental cost per QALY gained (ICER).
RESULTS: All nirsevimab immunization strategies reduced RSV-LRTI infections, hospitalizations, ICU admissions and deaths. The QALY loss in the catch-up strategy was the lowest (9.94), followed by year-round (11.11), seasonal (16.02), and no intervention (22.15). When compared with no intervention, ICERs for all nirsevimab strategies exceeded the willingness-to-pay (WTP) threshold (50,723 USD/QALY). The year-round and seasonal strategies had higher costs and QALY loss than catch-up strategy and were therefore dominated. No influential factors were identified in one-way sensitivity analysis. The extended one-way sensitivity analysis of the nirsevimab price indicated that catch-up strategy would be cost-effective (versus no intervention) when the drug cost was USD 105 or less at a WTP threshold of 50,723 USD/QALY.
CONCLUSIONS: The catch-up strategy for nirsevimab administration appears to be effective, and its cost-effectiveness in Hong Kong is highly subject to the drug cost.
METHODS: A Markov model with monthly cycle was developed to simulate the one-year outcomes of the 2024 birth cohort in Hong Kong (36,106 newborns). Four immunization strategies were evaluated in the model: (1) No intervention; (2) single-dose of nirsevimab at birth throughout the year (year- round); (3) single-dose nirsevimab at birth for infants born during the RSV season and at the start of the season for those born outside season (catch-up); (4) single-dose of nirsevimab to infants born during RSV season (seasonal). Model inputs were retrieved from public data and literature. Primary outcomes included RSV-LRTI related events, direct and indirect costs, quality-adjusted life year (QALY) loss, and incremental cost per QALY gained (ICER).
RESULTS: All nirsevimab immunization strategies reduced RSV-LRTI infections, hospitalizations, ICU admissions and deaths. The QALY loss in the catch-up strategy was the lowest (9.94), followed by year-round (11.11), seasonal (16.02), and no intervention (22.15). When compared with no intervention, ICERs for all nirsevimab strategies exceeded the willingness-to-pay (WTP) threshold (50,723 USD/QALY). The year-round and seasonal strategies had higher costs and QALY loss than catch-up strategy and were therefore dominated. No influential factors were identified in one-way sensitivity analysis. The extended one-way sensitivity analysis of the nirsevimab price indicated that catch-up strategy would be cost-effective (versus no intervention) when the drug cost was USD 105 or less at a WTP threshold of 50,723 USD/QALY.
CONCLUSIONS: The catch-up strategy for nirsevimab administration appears to be effective, and its cost-effectiveness in Hong Kong is highly subject to the drug cost.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE210
Topic
Economic Evaluation
Disease
SDC: Infectious Disease (non-vaccine), SDC: Pediatrics, SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)