Cost-Effectiveness of Strategies to Prevent Respiratory Syncytial Virus Infections Among Infants in Ireland
Author(s)
Marion Fahey, MPH, MPhil1, Leah Russell, BSc, MSc1, Ahuva Averin, MPP2, Erin Quinn, BS2, Mark Atwood, MS2, Amy Law, MS, PharmD3, Diana Mendes, PhD4.
1Pfizer, Dublin, Ireland, 2Avalere Health, Washington, DC, USA, 3Pfizer, New York, NY, USA, 4Pfizer Ltd., Tadworth, United Kingdom.
1Pfizer, Dublin, Ireland, 2Avalere Health, Washington, DC, USA, 3Pfizer, New York, NY, USA, 4Pfizer Ltd., Tadworth, United Kingdom.
OBJECTIVES: To prevent lower respiratory tract disease due to respiratory syncytial virus (RSV-LRTD) in infants, the European Medicines Agency has authorized maternal vaccination (RSVpreF) and monoclonal antibody (nirsevimab) for infants. While the Health Technology Assessment of both interventions is ongoing, for the 2024/2025 season, nirsevimab was offered to infants born in Ireland as part of a temporary, publicly funded pilot program. We evaluated the cost-effectiveness of a mixed strategy (referred to as a ‘combination’ or ‘complementary’ strategy in the literature) including both RSVpreF and nirsevimab in Ireland.
METHODS: A population-based model evaluated the clinical and economic outcomes associated with RSV-LRTD and the lifetime impact of preventing disease in infancy via immunization. Model inputs included population characteristics, disease rates, fatality rates, intervention effectiveness, medical costs, immunization costs, and indirect costs associated with productivity loss; inputs were based principally on Irish data. Cost-effectiveness was evaluated for a mixed strategy of seasonal RSVpreF with nirsevimab administered only to unprotected infants (uptake: RSVpreF, 62%; nirsevimab, 83%) versus nirsevimab alone (uptake: 83%). Intervention prices: RSVpreF, €202.95; nirsevimab, €370.38.
RESULTS: With nirsevimab alone, there were 1,094 RSV episodes requiring hospitalization (RSV-H) and 256 episodes requiring a general-practitioner visit (RSV-GP); total associated costs were €30.3 million (direct medical care [€10.4M] and intervention [€19.3M] costs: €29.7M; indirect costs: €0.6M). The mixed strategy resulted in 1,032 RSV-H and 271 RSV-GP episodes; total associated costs were €28.0M (direct medical care [€9.8M] and intervention costs [€17.6M]: €27.4M; indirect costs: €0.6M). With fewer RSV-H episodes and lower intervention costs, the mixed strategy yielded more quality-adjusted life-years and lower costs overall, making it dominant versus nirsevimab alone.
CONCLUSIONS: Findings suggest that using a combination of both preventives synergistically would be more effective in reducing RSV-LRTD among infants and a more efficient use of resources than a single intervention in Ireland.
METHODS: A population-based model evaluated the clinical and economic outcomes associated with RSV-LRTD and the lifetime impact of preventing disease in infancy via immunization. Model inputs included population characteristics, disease rates, fatality rates, intervention effectiveness, medical costs, immunization costs, and indirect costs associated with productivity loss; inputs were based principally on Irish data. Cost-effectiveness was evaluated for a mixed strategy of seasonal RSVpreF with nirsevimab administered only to unprotected infants (uptake: RSVpreF, 62%; nirsevimab, 83%) versus nirsevimab alone (uptake: 83%). Intervention prices: RSVpreF, €202.95; nirsevimab, €370.38.
RESULTS: With nirsevimab alone, there were 1,094 RSV episodes requiring hospitalization (RSV-H) and 256 episodes requiring a general-practitioner visit (RSV-GP); total associated costs were €30.3 million (direct medical care [€10.4M] and intervention [€19.3M] costs: €29.7M; indirect costs: €0.6M). The mixed strategy resulted in 1,032 RSV-H and 271 RSV-GP episodes; total associated costs were €28.0M (direct medical care [€9.8M] and intervention costs [€17.6M]: €27.4M; indirect costs: €0.6M). With fewer RSV-H episodes and lower intervention costs, the mixed strategy yielded more quality-adjusted life-years and lower costs overall, making it dominant versus nirsevimab alone.
CONCLUSIONS: Findings suggest that using a combination of both preventives synergistically would be more effective in reducing RSV-LRTD among infants and a more efficient use of resources than a single intervention in Ireland.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE277
Topic
Economic Evaluation, Health Technology Assessment, Methodological & Statistical Research
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory), Vaccines