Cost-Effectiveness of Mixed-Approach Maternal RSVpreF/Infant Nirsevimab Immunization vs. Nirsevimab Alone for Prevention of Respiratory Syncytial Virus in Spain
Author(s)
Alejandra López-Ibáñez de Aldecoa, MBA, MSc, PhD1, Vanessa López, Pharm1, Ahuva Averin, MPP2, Erin Quinn, BS2, Amy Law, MS, PharmD3.
1Pfizer, Alcobendas, Madrid, Spain, 2Avalere Health, Washington, DC, USA, 3Pfizer, New York, NY, USA.
1Pfizer, Alcobendas, Madrid, Spain, 2Avalere Health, Washington, DC, USA, 3Pfizer, New York, NY, USA.
OBJECTIVES: RSVpreF maternal vaccine and nirsevimab monoclonal antibody are authorized in Europe to prevent respiratory syncytial virus (RSV) due to lower respiratory tract illness (LRTI; RSV-LRTI) among infants. In Spain, only nirsevimab is currently recommended, however, a mixed approach (MA) for immunization comprising RSVpreF plus nirsevimab for unprotected infants has been deployed elsewhere in Europe. MA may increase immunization coverage, reduce RSV-LRTI burden, and be more cost-effective. We therefore evaluated the cost-effectiveness of MA versus nirsevimab alone (NA) to prevent RSV-LRTI among infants in Spain.
METHODS: A cohort model was developed to evaluate clinical outcomes (cases, deaths, quality-adjusted life-years [QALYs]) and economic costs (medical care, intervention, indirect [work-loss]) associated with RSV-LRTI for infants aged <1 year (n=360,633) and the impact of RSV-related death. RSVpreF (uptake: 72%) was administered seasonally to target infants born October-March. Nirsevimab was administered at birth for infants born October-March (uptake: 91.0%) and in October for April-September births (uptake: 76.5%). Cost-effectiveness of MA vs. NA was evaluated considering two alternative sources for hospitalization rates: 2016-2019 national data (Scenario 1), 2017-2018 regional data (Scenario 2).
RESULTS: With NA in Scenario 1, there were 14,411 RSV-LRTI cases (including 3,600 hospitalizations) with associated costs of 247.5 million (M) € (medical: 19.6M €; intervention: 225.2M €; indirect: 2.7M €). MA prevented 134 hospitalizations, yielded 2 QALYs, reduced total costs by 63.0M € (medical: 0.1M €; intervention: 62.9M €), and was thus dominant (vs. NA). With NA in Scenario 2, there were 15,363 cases (including 4,553 hospitalizations) with associated costs of 252.6M € (medical: 24.3M €; intervention: 225.2M €; indirect: 3.0M €). MA prevented 416 hospitalizations, yielded 19 QALYs, and reduced costs by 64.4M € (medical: 1.4M €; intervention: 62.9M €; indirect: 0.1M €), yielding a dominant cost-effectiveness ratio.
CONCLUSIONS: Adding RSVpreF to the recommendation would reduce the burden of RSV-LRTI among infants in Spain.
METHODS: A cohort model was developed to evaluate clinical outcomes (cases, deaths, quality-adjusted life-years [QALYs]) and economic costs (medical care, intervention, indirect [work-loss]) associated with RSV-LRTI for infants aged <1 year (n=360,633) and the impact of RSV-related death. RSVpreF (uptake: 72%) was administered seasonally to target infants born October-March. Nirsevimab was administered at birth for infants born October-March (uptake: 91.0%) and in October for April-September births (uptake: 76.5%). Cost-effectiveness of MA vs. NA was evaluated considering two alternative sources for hospitalization rates: 2016-2019 national data (Scenario 1), 2017-2018 regional data (Scenario 2).
RESULTS: With NA in Scenario 1, there were 14,411 RSV-LRTI cases (including 3,600 hospitalizations) with associated costs of 247.5 million (M) € (medical: 19.6M €; intervention: 225.2M €; indirect: 2.7M €). MA prevented 134 hospitalizations, yielded 2 QALYs, reduced total costs by 63.0M € (medical: 0.1M €; intervention: 62.9M €), and was thus dominant (vs. NA). With NA in Scenario 2, there were 15,363 cases (including 4,553 hospitalizations) with associated costs of 252.6M € (medical: 24.3M €; intervention: 225.2M €; indirect: 3.0M €). MA prevented 416 hospitalizations, yielded 19 QALYs, and reduced costs by 64.4M € (medical: 1.4M €; intervention: 62.9M €; indirect: 0.1M €), yielding a dominant cost-effectiveness ratio.
CONCLUSIONS: Adding RSVpreF to the recommendation would reduce the burden of RSV-LRTI among infants in Spain.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE261
Topic
Clinical Outcomes, Economic Evaluation, Methodological & Statistical Research
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Pediatrics, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory), Vaccines