RSV prevention tools are somewhat cost-effective, studies show

Investigators from the University of Michigan and the Centers for Disease Control and Prevention (CDC) have determined that maternal vaccination against respiratory syncytial virus (RSV) and the monoclonal antibody nirsevimab are likely cost-effective in certain situations against RSV.

These results, both published today in Pediatricswere presented to the CDC’s Advisory Committee on Immunization Practices (ACIP) and were instrumental in recommending these products.

Both studies evaluated the cost-effectiveness of these products for infants during their first RSV season; The maternal vaccine is given between weeks 32 and 36 of pregnancy, with maternal antibodies passing across the placenta.

The monoclonal antibody is administered as a single injection to infants under 8 months of age before their first RSV season if they have not received maternal vaccination. Older babies at risk for severe RSV may also receive nirsevimab during their second RSV season.

Fewer doses of nirsevimab are needed to protect

For the first studywhich examined the cost-effectiveness of maternal vaccination, the authors assumed a seasonal strategy with vaccination administered from September to January, corresponding to the peak RSV season.

With an assumed cost of $295 per vaccine dose plus administration costs, the incremental cost-effectiveness ratio (ICER) is calculated to be $163,513 per quality-adjusted life year (QALY) saved. This compares to $396,280 per QALY for year-round vaccination.

The model predicted that vaccinating approximately half of all U.S. pregnant women in the U.S. birth cohort would prevent 45,693 outpatient visits, 15,866 emergency department (ED) visits, and 7,571 RSV-related hospitalizations. in infants each year.

For nirsevimabthe antibody was found to be highly effective in preventing RSV-related hospitalizations and other serious outcomes, yielding an ICER of $153,517 per QALY saved, assuming a cost of $495 in the private sector and $395 under the Vaccines for Children program.

To avoid hospitalization of an infant, the authors found that 234 pregnant women would need to be vaccinated. The number of patients to administer nirsevimab to avoid hospitalization due to RSV was 128.

Researchers estimated that 107,253 outpatient visits, 38,204 emergency room visits, and 14,341 hospitalizations could be avoided each year if half of eligible U.S. babies received nirsevimab.

Both vaccines and antibody injection are expensive

Although both interventions are shown to be cost-effective, the high market prices of the products, particularly nirsevimab, mean that the interventions incur significant societal costs. The cost of a single dose of maternal vaccine is $295, while the commercial cost of nirsevimab is $495. For comparison, the annual flu vaccine costs between $19 and $32 per dose.

In a comment Of studies conducted by Sean O’Leary, MD, MPH, University of Colorado School of Medicine, O’Leary said that in the analysis of nirsevimab, if the cost per dose was $50, the medication would save money.

It is conceivable that market forces will drive down the remarkably high costs of these products.

“While it is unlikely that costs will fall that much in the coming years,” he wrote, “with several other RSV prevention products in the pipeline, it is conceivable that market forces will reduce the remarkably high costs of these products.