BACKGROUND AND OBJECTIVES Respiratory syncytial virus (RSV) causes substantial hospitalization in US infants. The Advisory Committee on Immunization Practices recommended nirsevimab in infants younger than 8 months born during or entering their first RSV season and for children aged 8 to 19 months at increased risk of RSV hospitalization in their second season. This study's objective was to evaluate the cost-effectiveness of nirsevimab in all infants in their first RSV season and in high-risk children in their second season. METHODS We simulated healthcare utilization and deaths from RSV with and without nirsevimab among infants aged 0 to 7 months and those 8 to 19 months old over a single RSV season. Data came from published literature, US Food and Drug Administration approval documents, and epidemiologic surveillance data. We evaluated societal outcomes over a lifetime discounting at 3% and reporting in 2022 US dollars. Sensitivity and scenario analyses identified influential variables. RESULTS We estimated that 107 253 outpatient visits, 38 204 emergency department visits, and 14 341 hospitalizations could be averted each year if half of the US birth cohort receives nirsevimab. This would cost $153 517 per quality-adjusted life year (QALY) saved. Nirsevimab in the second season for children facing a 10-fold higher risk of hospitalization would cost $308 468 per QALY saved. Sensitivity analyses showed RSV hospitalization costs, nirsevimab cost, and QALYs lost from RSV disease were the most influential parameters with cost-effectiveness ratios between cost-saving and $323 788 per QALY saved. CONCLUSIONS Nirsevimab for infants may be cost-effective, particularly among those with higher risks and costs of RSV.

中文翻译：

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Nirsevimab 治疗婴幼儿呼吸道合胞病毒的成本效益。


背景和目标 呼吸道合胞病毒 （RSV） 导致美国婴儿大量住院。免疫实践咨询委员会建议对在第一个 RSV 季节出生或进入 RSV 季节的 8 个月以下婴儿以及第二个季节 RSV 住院风险增加的 8 至 19 个月大的儿童使用 nirsevimab。本研究的目的是评估 nirsevimab 在第一个 RSV 季节的所有婴儿和第二个季节的高危儿童中的成本效益。方法 我们模拟了 0 至 7 个月大的婴儿和 8 至 19 个月大的婴儿在一个 RSV 季节内有和没有 nirsevimab 的 RSV 的医疗保健利用和死亡。数据来自已发表的文献、美国食品药品监督管理局 （FDA） 批准文件和流行病学监测数据。我们评估了一生中的社会成果，贴现 3%，并以 2022 年美元报告。敏感性和情景分析确定了影响变量。结果我们估计，如果美国出生队列中有一半接受 nirsevimab，每年可以避免 107 253 次门诊就诊、38 204 次急诊就诊和 14 341 次住院治疗。每节省一个质量调整生命年 （QALY） 将花费 153 517 美元。对于住院风险高出 10 倍的儿童，第二季的 Nirsevimab 每节省 QALY 将花费 308 468 美元。敏感性分析显示 RSV 住院费用、nirsevimab 成本和 RSV 疾病损失的 QALY 是最具影响力的参数，成本效益比介于节省成本与每节省 QALY 323 788 美元之间。结论 Nirsevimab 用于婴儿可能具有成本效益，尤其是在 RSV 风险和成本较高的人群中。