英国RSV患儿抗病毒治疗的成本效益

IF 4.5 3区医学 Q2 IMMUNOLOGY

Vaccine Pub Date : 2025-01-25 DOI:10.1016/j.vaccine.2024.126647

Yonas Gebrecherkos, David Hodgson

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引用次数: 0

摘要

背景：呼吸道合胞病毒（RSV）是全世界婴儿住院的常见原因，可引起显著的发病率和死亡率。最近，在一项针对因呼吸道合胞病毒住院的婴儿进行的III期试验中，抗病毒治疗Ziresovir显示出了令人鼓舞的结果。基于这些结果，本研究旨在调查Ziresovir在英国（UK）的成本效益。方法：成本效益分析（CEA）采用比例结果模型，利用AIRFLO试验的一线报告数据和已发表的数据来探讨Ziresovir给药对年龄住院婴儿的影响。结果：对所有住院婴儿给予Ziresovir每年可避免4例死亡（范围：2.8-4.5），216例ICU住院（范围：160-260）和3169例ICU住院日（范围：2348-3804），每位住院婴儿Ziresovir的MCEP为429.65英镑（95% CrI: 236- 771英镑）。如果针对早产儿，则MCEP增加到2108.38英镑（95%:870英镑- 3540英镑）。专门治疗患有慢性肺病（CLD）和先天性心脏病（CHD）的婴儿的MCEP分别为6557.24英镑（95%克朗：1250英镑- 14,920英镑）和9459.44英镑（95%克朗：3350英镑- 20,300英镑）。该模型对Ziresovir疗效、ICU入院风险和死亡率的变化高度敏感。结论：如果价格低于每剂430英镑，Ziresovir对所有因RSV住院的婴儿是一种具有成本效益的干预措施，而专门治疗高危- CLD和CHD婴儿的策略分别为6558英镑和9460英镑。结果对Ziresovir的疗效高度敏感，当AIRFLO试验的全部结果可用时，结果可以得到改善。

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Cost-effectiveness of anti-viral treatment for infants with RSV disease in the United Kingdom

Background

Respiratory Syncytial Virus (RSV) is a common cause of hospitalisation in infants worldwide, causing significant morbidity and mortality. Recently, the antiviral treatment, Ziresovir, has shown promising results in a Phase III trial conducted on infants hospitalised with RSV. Based on these topline results, this study aims to investigate the cost-effectiveness of Ziresovir in the United Kingdom (UK).

Methods

The cost-effective analysis (CEA) uses a proportional outcomes model using data from topline reports by the AIRFLO trial and published data to explore the effect of Ziresovir administration on hospitalised infants aged <24 months at admission. We estimated the reduction in ICU bed days and deaths and the maximum cost-effective price (MCEP) per treated individual, assuming a threshold of £20,000 per Quality-adjusted Life Year (QALY) gained.

Results

Administering Ziresovir to all hospitalised infants averts four deaths (range: 2.8–4.5), 216 ICU admissions (range:160–260) and 3169 ICU bed-days (range: 2348–3804) per annum, the MCEP for Ziresovir per hospitalised infant is £429.65 (95 % CrI: £236–£771). If preterm infants are targeted, then the MCEP increases to £2108.38 (95 % Crl: £870–£3540). The MCEP for exclusively treating Infants with Chronic Lung Disease (CLD) and Congenital Heart Disease (CHD) is £6557.24 (95 % Crl: £1250 - £14,920) and £9459.44 (95 % Crl £3350–£20,300) respectively. The model is highly sensitive to changes in the efficacy of Ziresovir and the risk of ICU admission and mortality.

Conclusion

Ziresovir is a cost-effective intervention for all infants hospitalised with RSV if priced below £430 per dose and strategies that exclusively treat high-risk- with CLD and CHD infants justify a higher price of £6558 and £9460 respectively. The outcomes are highly sensitive to the efficacy of Ziresovir and can be improved when the full results of the AIRFLO trial are available.

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来源期刊

Vaccine 医学-免疫学

CiteScore

8.70

自引率

5.50%

发文量

992

审稿时长

131 days

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