COST-EFFECTIVENESS OF STRATEGIES TO PREVENT RESPIRATORY SYNCYTIAL VIRUS HOSPITALIZATION AMONG INFANTS IN AUSTRIA
Author(s)
Martin Zurl, PhD1, Rengina Kefalogianni, MSc2, Ahuva Averin, MPP3, Viola Hedrich, PhD1, Gülsen Sever, MD4, Angelika Berger, MD5, Philipp Foessleitner, MD, PhD5, Patrick Stelzl, MD6, Erin Quinn, BS3, Mary MacKinnon, BS3, Diana Mendes, PhD7.
1Pfizer Austria, Vienna, Austria, 2Pfizer, London, United Kingdom, 3Avalere Health, Washington, DC, USA, 4Medical University of Graz, Graz, Austria, 5Medical University of Vienna, Vienna, Austria, 6Sankt Josef Hospital, Vienna, Austria, 7Pfizer Ltd., Tadworth, United Kingdom.
1Pfizer Austria, Vienna, Austria, 2Pfizer, London, United Kingdom, 3Avalere Health, Washington, DC, USA, 4Medical University of Graz, Graz, Austria, 5Medical University of Vienna, Vienna, Austria, 6Sankt Josef Hospital, Vienna, Austria, 7Pfizer Ltd., Tadworth, United Kingdom.
OBJECTIVES: In Austria, either nirsevimab for infants or maternal RSVpreF vaccination for pregnant women with October-March due dates is recommended to prevent lower respiratory tract disease due to respiratory syncytial virus (RSV-LRTD) in infants. However, only nirsevimab is included in the national immunization program. We evaluated the cost-effectiveness of maternal RSVpreF vaccination complemented by nirsevimab for infants not protected by maternal vaccination (“complementary”) compared with nirsevimab administration for all infants (“nirsevimab alone”).
METHODS: A cohort model evaluated clinical and economic outcomes of RSV-LRTD hospitalization among infants aged <1 year (n=77,235) and the impact of immunization strategies. The complementary strategy modelled RSVpreF (list price: €165; uptake: 50%) for eligible pregnant women and nirsevimab for unprotected infants (list price: €350; uptake: 80%). The nirsevimab alone strategy assumed 80% uptake among all infants. Scenario analyses assessed maternal benefits from RSVpreF, reductions in RSV-related sequelae (RSV-S; recurrent LRTD, wheezing), and alternative uptake scenarios. Costs and benefits were discounted at 3%/year, and cost-effectiveness was assessed in terms of incremental cost per quality-adjusted life-year gained.
RESULTS: With nirsevimab alone, 789 RSV-LRTD hospitalizations occurred, associated with €11.5M in medical care costs; intervention costs totaled €22.1M. The complementary strategy prevented 33 additional RSV-LRTD hospitalizations, yielded 3 additional quality-adjusted life-years, and reduced medical care costs by €484K; intervention costs were €1.9M lower. The complementary strategy was dominant versus nirsevimab alone, with savings of €74K per RSV-LRTD hospitalization averted. It also prevented 17 maternal RSV-LRTD hospitalizations, yielding an additional €141K in savings. Reductions in RSV-S generated a further €360K in savings.
CONCLUSIONS: Maternal RSVpreF combined with nirsevimab for infants not protected by maternal vaccination would reduce RSV-LRTD hospitalizations and overall healthcare costs. RSVpreF may also benefit pregnant and postpartum women and reduce RSV-S in young children. To achieve the modelled 50% uptake of RSVpreF in Austria, targeted implementation strategies would need to be considered.
METHODS: A cohort model evaluated clinical and economic outcomes of RSV-LRTD hospitalization among infants aged <1 year (n=77,235) and the impact of immunization strategies. The complementary strategy modelled RSVpreF (list price: €165; uptake: 50%) for eligible pregnant women and nirsevimab for unprotected infants (list price: €350; uptake: 80%). The nirsevimab alone strategy assumed 80% uptake among all infants. Scenario analyses assessed maternal benefits from RSVpreF, reductions in RSV-related sequelae (RSV-S; recurrent LRTD, wheezing), and alternative uptake scenarios. Costs and benefits were discounted at 3%/year, and cost-effectiveness was assessed in terms of incremental cost per quality-adjusted life-year gained.
RESULTS: With nirsevimab alone, 789 RSV-LRTD hospitalizations occurred, associated with €11.5M in medical care costs; intervention costs totaled €22.1M. The complementary strategy prevented 33 additional RSV-LRTD hospitalizations, yielded 3 additional quality-adjusted life-years, and reduced medical care costs by €484K; intervention costs were €1.9M lower. The complementary strategy was dominant versus nirsevimab alone, with savings of €74K per RSV-LRTD hospitalization averted. It also prevented 17 maternal RSV-LRTD hospitalizations, yielding an additional €141K in savings. Reductions in RSV-S generated a further €360K in savings.
CONCLUSIONS: Maternal RSVpreF combined with nirsevimab for infants not protected by maternal vaccination would reduce RSV-LRTD hospitalizations and overall healthcare costs. RSVpreF may also benefit pregnant and postpartum women and reduce RSV-S in young children. To achieve the modelled 50% uptake of RSVpreF in Austria, targeted implementation strategies would need to be considered.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE601
Topic
Clinical Outcomes, Economic Evaluation, Epidemiology & Public Health
Disease
Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory), Vaccines