Passive immunisation against respiratory syncytial virus: a cost-effectiveness analysis.

Area of Science:

• Pediatric Infectious Diseases
• Health Economics
• Public Health Policy

Background:

• Respiratory Syncytial Virus (RSV) poses a significant health burden on high-risk infants.
• Passive immunisation is a strategy to mitigate RSV-related hospitalisations.
• Evaluating the economic viability of such interventions is crucial for healthcare resource allocation.

Purpose of the Study:

• To assess the cost-effectiveness of passive immunisation against RSV in high-risk children in the Netherlands.
• To determine the incremental costs to prevent one hospitalisation using an individualized monthly approach.

Main Methods:

• Cost-effectiveness analysis integrating hospitalisation costs, monthly risks, immunisation expenses, and efficacy.
• Modeling a reference case with highest risk factors (e.g., prematurity, bronchopulmonary dysplasia).
• Sensitivity and cost-neutrality analyses were conducted.

Main Results:

• Cost-effectiveness varied significantly based on child characteristics and season, with the highest efficacy in December (€13,190 per averted hospitalisation).
• Hospitalisation risk was the most influential factor.
• Cost neutrality required substantial reductions in immunisation costs or increases in hospitalisation costs/risk.

Conclusions:

• Passive immunisation against RSV in high-risk infants demonstrated high incremental costs per hospitalisation averted.
• A restrictive policy, targeting children with bronchopulmonary dysplasia during high-risk months, is advised.
• Significant reductions in passive immunisation costs are necessary for improved cost-effectiveness.