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Published on: January 26, 2019
Disease Burden Associated with All Infants in Their First RSV Season in the UK: A Static Model of Universal
Alexia Kieffer1, Matthieu Beuvelet1, Gerald Moncayo1
1Sanofi, Lyon, France.
Insights
Universal nirsevimab immunization in the UK can significantly reduce respiratory syncytial virus (RSV) lower respiratory tract disease (LRTD) and associated costs for all infants. This strategy offers substantial health and economic benefits, preventing nearly 200,000 LRTDs annually.
Area of Science:
- * Pediatrics
- * Public Health
- * Immunology
Background:
- * Respiratory syncytial virus (RSV) causes significant illness in UK newborns.
- * Nirsevimab, a long-acting monoclonal antibody, is approved for preventing RSV lower respiratory tract disease (LRTD) in infants.
- * This study assesses nirsevimab's impact on RSV-LRTDs, costs, and quality-adjusted life years (QALYs) in infants during their first RSV season.
Purpose of the Study:
- * To evaluate the potential impact of universal nirsevimab administration versus palivizumab for high-risk infants.
- * To quantify the reduction in RSV-associated LRTDs, healthcare costs, and QALYs lost.
- * To analyze the economic value of nirsevimab in a UK birth cohort.
Main Methods:
- * A static decision-analytic model was used for a UK birth cohort.
- * Compared universal nirsevimab immunization to palivizumab for high-risk infants.
- * Modeled RSV-related events: primary care visits, A&E visits, hospitalizations (including ICU), recurrent wheezing, and all-cause LRTD hospitalizations.
Main Results:
- * Without intervention, RSV causes an estimated 329,425 LRTDs and 24,381 hospitalizations/ICU admissions annually, costing £117.8 million.
- * Universal nirsevimab could prevent 198,886 LRTDs and 16,657 hospitalizations/ICU admissions, saving £77.2 million.
- * The value of universal nirsevimab ranges from £243 to £274 per infant, based on WTP thresholds of £20,000-£30,000 per QALY.
Conclusions:
- * A universal nirsevimab immunization strategy substantially reduces the health and economic burden of RSV in the UK.
- * Benefits extend to all infants, including term, preterm, and those eligible for palivizumab.
- * Nirsevimab offers a cost-effective approach to managing RSV in the first year of life.
Introduction:
Respiratory syncytial virus (RSV) leads to significant morbidity in newborn infants in the United Kingdom (UK). Nirsevimab, a long-acting monoclonal antibody, received approval from the European Medicines Agency and has been licensed by the Medicines and Healthcare products Regulatory Agency for preventing RSV lower respiratory tract disease (LRTD) in neonates and infants during their first RSV season. The objective of this study was to assess the potential impact of nirsevimab on RSV-associated LRTDs, related costs, and loss of quality-adjusted life years (QALYs) in infants experiencing their first RSV season.
Methods:
The impact of administering nirsevimab across all infant populations compared to palivizumab in the high-risk palivizumab-eligible population was assessed via a static decision-analytic model specified for a UK birth cohort experiencing their first RSV season. The RSV-related health events of interest included primary care (PC), accident and emergency (A&E) visits, hospitalizations [including hospitalizations alone and those resulting in intensive care unit (ICU) admissions], recurrent wheezing in infants who were previously hospitalized, and all-cause LRTD hospitalizations.
Results:
Under the current standard of practice (SoP), RSV was estimated to result in 329,425 RSV LRTDs annually, including 24,381 hospitalizations and ICU admissions, representing £117.8 million (2024 GBP) in costs. Comparatively, universal immunization of all infants with nirsevimab could avoid 198,886 RSV LRTDs, including 16,657 hospitalizations and ICU admissions, resulting in savings of £77.2 million in RSV treatment costs. Considering the impact on all-cause LRTD of a universal immunization strategy, nirsevimab could be valued between £243 and £274, assuming willingness-to-pay (WTP) thresholds of £20,000 and £30,000 per QALY saved, respectively.
Conclusions:
This analysis demonstrated that the health and economic burden of RSV would be substantially reduced in all infants experiencing their first RSV season in the UK (including term, preterm, and palivizumab-eligible infants) as a result of a universal immunization strategy with nirsevimab.
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