Cost-effectiveness of Respiratory Syncytial Virus Disease Prevention Strategies: Maternal Vaccine Versus Seasonal or Year-Round Monoclonal Antibody Program in Norwegian Children
Respiratory Syncytial Virus Consortium in Europe (RESCEU) Investigators
(2022) The Journal of infectious diseases, volume 226, issue Supplement_1, pp. S95 - S101
(Article)
Abstract
BACKGROUND: Every winter, respiratory syncytial virus (RSV) disease results in thousands of cases in Norwegian children under 5 years of age. We aim to assess the RSV-related economic burden and the cost-effectiveness of upcoming RSV disease prevention strategies including year-round maternal immunization and year-round and seasonal monoclonal antibody (mAb) programs.
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METHODS: Epidemiological and cost data were obtained from Norwegian national registries, while quality-adjusted life-years (QALYs) lost and intervention characteristics were extracted from literature and phase 3 clinical trials. A static model was used and uncertainty was accounted for probabilistically. Value of information was used to assess decision uncertainty. Extensive scenario analyses were conducted, including accounting for long-term consequences of RSV disease. RESULTS: We estimate an annual average of 13 517 RSV cases and 1572 hospitalizations in children under 5, resulting in 79.6 million Norwegian kroner (~€8 million) treatment costs. At €51 per dose for all programs, a 4-month mAb program for neonates born in November to February is the cost-effective strategy for willingness to pay (WTP) values up to €40 000 per QALY gained. For higher WTP values, the longer 6-month mAb program that immunizes neonates from October to March becomes cost-effective. Sensitivity analyses show that year-round maternal immunization can become a cost-effective strategy if priced lower than mAb. CONCLUSIONS: Assuming the same pricing, seasonal mAb programs are cost-effective over year-round programs in Norway. The timing and duration of the cost-effective seasonal program are sensitive to the pattern of the RSV season in a country, so continued RSV surveillance data are essential.
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Keywords: cost-utility analysis, disease burden, expected value of perfect information, maternal immunization, monoclonal antibody, respiratory syncytial virus, seasonal program, vaccines, Respiratory Syncytial Virus Infections/drug therapy, Humans, Antibodies, Monoclonal, Humanized/therapeutic use, Antibodies, Monoclonal/therapeutic use, Child, Preschool, Infant, Respiratory Syncytial Viruses, Palivizumab/therapeutic use, Antiviral Agents/therapeutic use, Cost-Benefit Analysis, Vaccines/therapeutic use, Seasons, Child, Communicable Diseases/drug therapy, Infant, Newborn, Infectious Diseases, Immunology and Allergy, Research Support, Non-U.S. Gov't, Journal Article
ISSN: 0022-1899
Publisher: Oxford University Press
Note: Publisher Copyright: © The Author(s) 2022. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. F.
(Peer reviewed)