Cost-effectiveness of Respiratory Syncytial Virus Disease Prevention Strategies: Maternal Vaccine Versus Seasonal or Year-Round Monoclonal Antibody Program in Norwegian Children

Autor: Li, Xiao, Bilcke, Joke, Vázquez Fernández, Liliana, Bont, Louis, Willem, Lander, Wisløff, Torbjørn, Jit, Mark, Beutels, Philippe, Nair, Harish, Campbell, Harry, Pollard, Andrew, Openshaw, Peter, Martinon-Torres, Federico, Heikkinen, Terho, Meijer, Adam, Fischer, Thea K, van den Berge, Maarten, Giaquinto, Carlo, Abram, Michael, Swanson, Kena, Rizkalla, Bishoy, Vernhes, Charlotte, Gallichan, Scott, Aerssens, Jeroen, Kumar, Veena, Molero, Eva
Přispěvatelé: REsp Syncytial Virus Consortium EU (RESCEU)
Rok vydání: 2022
Předmět:
Zdroj: The journal of infectious diseases
ISSN: 1537-6613
0022-1899
DOI: 10.1093/infdis/jiac064
Popis: 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. 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.
Databáze: OpenAIRE