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The following is a summary of “Cost-Effectiveness of Nirsevimab for Respiratory Syncytial Virus in Infants and Young Children,” published in the November 2024 issue of Pediatrics by Hutton et al.
Respiratory syncytial virus (RSV) leads to significant hospitalizations among infants in the United States. The Advisory Committee on Immunization Practices (ACIP) recommended nirsevimab for infants younger than 8 months during their first RSV season and for children aged 8 to 19 months at high risk of RSV hospitalization in their second season.
Researchers conducted a prospective study evaluating the cost-effectiveness of nirsevimab for all infants during their first RSV season and for children at high risk during their second season.
They simulated healthcare utilization and RSV-related deaths for infants aged 0 to 7 months and children aged 8 to 19 months with and without nirsevimab during a single RSV season. Data from published literature, U.S. FDA approval documents, and epidemiologic surveillance were used. Societal outcomes were evaluated with lifetime discounting at 3%, with results reported in 2022 U.S. dollars.
The results showed 107,253 outpatient visits, 38,204 ED visits, and 14,341 hospitalizations. The cost per quality-adjusted life year (QALY) saved would be $153,517. For children at a 10-fold higher risk of RSV hospitalization, nirsevimab would cost $308,468 per QALY saved. Sensitivity analyses showed that the most influential factors were RSV hospitalization costs, nirsevimab, and QALYs lost from RSV disease, with cost-effectiveness ratios ranging from cost-saving to $323,788 per QALY saved.
They concluded that nirsevimab may be cost-effective for infants, particularly for those with higher risks of RSV hospitalization.
