Rafael Bolanos, Rafael Araos, Cecilia Gonzalez, Dino Sepulveda, Juan Francisco Falconi, Ahuva Averin, Mark Atwood, Erin Quinn, Amy W Law, Diana Mendes
{"title":"使用预防干预措施保护智利婴儿免受呼吸道合胞体病毒感染战略的成本效益。","authors":"Rafael Bolanos, Rafael Araos, Cecilia Gonzalez, Dino Sepulveda, Juan Francisco Falconi, Ahuva Averin, Mark Atwood, Erin Quinn, Amy W Law, Diana Mendes","doi":"10.1080/14760584.2025.2562201","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract illness (LRTI; RSV-LRTI) among infants in Chile; young infants and infants born prematurely are at greatest risk.</p><p><strong>Research design and methods: </strong>A cohort model was developed to evaluate cost-effectiveness of strategies preventing RSV-LRTI in infants. Using the model, we calculated the economically justifiable price (EJP) of maternal RSVpreF vaccination (MV) versus no intervention and then evaluated the cost-effectiveness of MV (cost/dose assumed at EJP) with complementary use of monoclonal antibody nirsevimab for unprotected infants (MV+N) versus nirsevimab alone (NA) to prevent RSV-LRTI. Nirsevimab published price was $260.00; costs/prices reported in 2023 US$.</p><p><strong>Results: </strong>NA yielded 20,247 cases (hospital: 3,773, emergency ward: 16,474) and $57.2 million (M) in total costs (medical: $6.3 M, intervention: $48.7 M, indirect: $2.2 M). MV+N yielded 23,906 cases (hospital: 3,137, emergency ward: 20,769) and $28.7 M in costs (medical: $4.8 M, intervention: $21.7 M [RSVpreF assumed $75.77/dose; nirsevimab procured $260.00/dose], indirect: $2.2 M). With costs lower by $28.4 M and increased quality-adjusted life-years, MV+N would be cost-saving versus NA.</p><p><strong>Conclusions: </strong>RSVpreF vaccination among pregnant women along with nirsevimab for unprotected infants in Chile would be the most efficient use of resources, yielding substantial cost savings compared to use of nirsevimab alone.</p>","PeriodicalId":12326,"journal":{"name":"Expert Review of Vaccines","volume":" ","pages":"904-913"},"PeriodicalIF":4.8000,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Cost-effectiveness of strategies using preventive interventions to protect infants in Chile from respiratory syncytial virus.\",\"authors\":\"Rafael Bolanos, Rafael Araos, Cecilia Gonzalez, Dino Sepulveda, Juan Francisco Falconi, Ahuva Averin, Mark Atwood, Erin Quinn, Amy W Law, Diana Mendes\",\"doi\":\"10.1080/14760584.2025.2562201\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract illness (LRTI; RSV-LRTI) among infants in Chile; young infants and infants born prematurely are at greatest risk.</p><p><strong>Research design and methods: </strong>A cohort model was developed to evaluate cost-effectiveness of strategies preventing RSV-LRTI in infants. Using the model, we calculated the economically justifiable price (EJP) of maternal RSVpreF vaccination (MV) versus no intervention and then evaluated the cost-effectiveness of MV (cost/dose assumed at EJP) with complementary use of monoclonal antibody nirsevimab for unprotected infants (MV+N) versus nirsevimab alone (NA) to prevent RSV-LRTI. Nirsevimab published price was $260.00; costs/prices reported in 2023 US$.</p><p><strong>Results: </strong>NA yielded 20,247 cases (hospital: 3,773, emergency ward: 16,474) and $57.2 million (M) in total costs (medical: $6.3 M, intervention: $48.7 M, indirect: $2.2 M). MV+N yielded 23,906 cases (hospital: 3,137, emergency ward: 20,769) and $28.7 M in costs (medical: $4.8 M, intervention: $21.7 M [RSVpreF assumed $75.77/dose; nirsevimab procured $260.00/dose], indirect: $2.2 M). 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Cost-effectiveness of strategies using preventive interventions to protect infants in Chile from respiratory syncytial virus.
Background: Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract illness (LRTI; RSV-LRTI) among infants in Chile; young infants and infants born prematurely are at greatest risk.
Research design and methods: A cohort model was developed to evaluate cost-effectiveness of strategies preventing RSV-LRTI in infants. Using the model, we calculated the economically justifiable price (EJP) of maternal RSVpreF vaccination (MV) versus no intervention and then evaluated the cost-effectiveness of MV (cost/dose assumed at EJP) with complementary use of monoclonal antibody nirsevimab for unprotected infants (MV+N) versus nirsevimab alone (NA) to prevent RSV-LRTI. Nirsevimab published price was $260.00; costs/prices reported in 2023 US$.
Results: NA yielded 20,247 cases (hospital: 3,773, emergency ward: 16,474) and $57.2 million (M) in total costs (medical: $6.3 M, intervention: $48.7 M, indirect: $2.2 M). MV+N yielded 23,906 cases (hospital: 3,137, emergency ward: 20,769) and $28.7 M in costs (medical: $4.8 M, intervention: $21.7 M [RSVpreF assumed $75.77/dose; nirsevimab procured $260.00/dose], indirect: $2.2 M). With costs lower by $28.4 M and increased quality-adjusted life-years, MV+N would be cost-saving versus NA.
Conclusions: RSVpreF vaccination among pregnant women along with nirsevimab for unprotected infants in Chile would be the most efficient use of resources, yielding substantial cost savings compared to use of nirsevimab alone.
期刊介绍：
Expert Review of Vaccines (ISSN 1476-0584) provides expert commentary on the development, application, and clinical effectiveness of new vaccines. Coverage includes vaccine technology, vaccine adjuvants, prophylactic vaccines, therapeutic vaccines, AIDS vaccines and vaccines for defence against bioterrorism. All articles are subject to rigorous peer-review.
The vaccine field has been transformed by recent technological advances, but there remain many challenges in the delivery of cost-effective, safe vaccines. Expert Review of Vaccines facilitates decision making to drive forward this exciting field.
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