优化呼吸道综合细胞病毒预防干预的时间 婴儿的干预措施
Danielle Nguyen1, Haeseon Lee1, Andrew T Pavia2
1Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City.
JAMA network open
|July 23, 2025
概括
推使用母体疫苗 (MV) 和nirsevimab,以保护婴儿免受呼吸道同胞病毒 (RSV) 的感染. 对于季节早期出生婴儿的RSV预防,MV具有成本效益,而nirsevimab仅在最早的几个月内具有成本效益.
科学领域:
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
- 儿科 儿科 儿科
背景情况:
- 美国疾病控制和预防中心 (CDC) 建议使用母体疫苗 (MV) 或nirsevimab,以保护婴儿免受呼吸道同胞病毒 (RSV) 的感染.
- 这些干预措施的成本效益可能因服用时间,摄入量和疗效而异.
研究的目的:
- 评估母亲疫苗 (MV) 和尼尔塞维马布用于婴儿RSV预防的临床结果和成本效益.
- 将这些干预与每月出生队列和整个RSV季节的无干预进行比较.
主要方法:
- 从社会角度使用马尔科夫模型进行经济评估.
- 分析结合了每QALY15万美元的支付意愿门.
- 包括在RSV季节 (10月至2月) 在美国出生的婴儿.
主要成果:
- 孕产妇疫苗 (MV) 对于10月,11月和12月出生的婴儿来说是节省成本的,对于10月至2月的联合队列来说是具有成本效益的 (19,562美元/QALY).
- 与MV相比,Nirsevimab仅在10月 (67,178美元/QALY) 和11月 (88,531美元/QALY) 出生的婴儿中具有成本效益.
- 预计MV可以避免7,154例住院治疗和12例死亡;Nirsevimab在RSV季节预计可以避免11,893例住院治疗和19例死亡.
结论:
- 在前四个月和整个RSV季节内注射孕产妇疫苗 (MV) 可以具有成本效益.
- 与MV相比,nirsevimab仅在10月和11月出生的婴儿中表现出成本效益.
- 通过限制给药时间到特定的几个月来优化干预使用可能是有益的;需要进一步研究传播动态.
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