Cost-effectiveness of RSVpreF vaccine and nirsevimab for the prevention of respiratory syncytial virus disease in Canadian infants

Health Canada recently authorized the RSVpreF pregnancy vaccine and nirsevimab to protect infants against respiratory syncytial virus (RSV) disease. Assess the cost-effectiveness of RSVpreF and nirsevimab programs in preventing RSV disease in infants, compared to a palivizumab program. We used a sta...

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Bibliographic Details
Published in:Vaccine 2024-08, Vol.42 (21), p.126164, Article 126164
Main Authors: Gebretekle, Gebremedhin B., Yeung, Man Wah, Ximenes, Raphael, Cernat, Alexandra, Simmons, Alison E., Killikelly, April, Siu, Winnie, Rafferty, Ellen, Brousseau, Nicholas, Tunis, Matthew, Tuite, Ashleigh R.
Format: Article
Language:English
Subjects:
Births
Cost analysis
Cost effectiveness
Cost-utility
Disease prevention
Fatalities
Immunization
Impact analysis
Infants
Newborn babies
Nirsevimab
Pregnancy
Respiratory syncytial virus
RSV
RSVpreF
Uncertainty analysis
Vaccines
Womens health
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Summary:Health Canada recently authorized the RSVpreF pregnancy vaccine and nirsevimab to protect infants against respiratory syncytial virus (RSV) disease. Assess the cost-effectiveness of RSVpreF and nirsevimab programs in preventing RSV disease in infants, compared to a palivizumab program. We used a static cohort model of a Canadian birth cohort during their first RSV season to estimate sequential incremental cost-effectiveness ratios (ICERs) in 2023 Canadian dollars per quality-adjusted life year (QALY) for nine strategies implemented over a one-year time period, from the health system and societal perspectives. Sensitivity and scenario analyses were conducted to explore the impact of uncertainties on the results. All-infants nirsevimab programs averted more RSV-related outcomes than year-round RSVpreF programs, with the most RSV cases averted in a seasonal nirsevimab program with catch-up. Assuming list prices for these immunizing agents, all-infants nirsevimab and year-round RSVpreF programs were never cost-effective, with ICERs far exceeding commonly used cost-effectiveness thresholds. Seasonal nirsevimab with catch-up for infants born outside the RSV season was a cost-effective program if prioritized for infants at moderate/high-risk (ICER
ISSN:0264-410X
1873-2518
1873-2518
DOI:10.1016/j.vaccine.2024.126164