Cost-effectiveness of monoclonal antibody and maternal immunization against respiratory syncytial virus (RSV) in infants: Evaluation for six European countries

Respiratory Syncytial Virus Consortium in Europe (RESCEU) investigators

doi:10.1016/j.vaccine.2023.01.058

Cost-effectiveness of monoclonal antibody and maternal immunization against respiratory syncytial virus (RSV) in infants: Evaluation for six European countries

Respiratory Syncytial Virus Consortium in Europe (RESCEU) investigators

Health Economics Research Unit

Research output: Contribution to journal › Article › peer-review

10 Citations (Scopus)

Abstract

Background: Respiratory syncytial virus (RSV) imposes a substantial burden on pediatric hospital capacity in Europe. Promising prophylactic interventions against RSV including monoclonal antibodies (mAb) and maternal immunizations (MI) are close to licensure. Therefore, we aimed to evaluate the cost-effectiveness of potential mAb and MI interventions against RSV in infants, for six European countries. Methods: We used a static cohort model to compare costs and health effects of four intervention programs to no program and to each other: year-round MI, year-round mAb, seasonal mAb (October to April), and seasonal mAb plus a catch-up program in October. Input parameters were obtained from national registries and literature. Influential input parameters were identified with the expected value of partial perfect information and extensive scenario analyses (including the impact of interventions on wheezing and asthma). Results: From the health care payer perspective, and at a price of €50 per dose (mAb and MI), seasonal mAb plus catch-up was cost-saving in Scotland, and cost-effective for willingness-to-pay (WTP) values ≥€20,000 (England, Finland) or €30,000 (Denmark) per quality adjusted life-year (QALY) gained for all scenarios considered, except when using ICD-10 based hospitalization data. For the Netherlands, seasonal mAb was preferred (WTP value: €30,000-€90,000) for most scenarios. For Veneto region (Italy), either seasonal mAb with or without catch-up or MI was preferred, depending on the scenario and WTP value. From a full societal perspective (including leisure time lost), the seasonal mAb plus catch-up program was cost-saving for all countries except the Netherlands. Conclusion: The choice between a MI or mAb program depends on the level and duration of protection, price, availability, and feasibility of such programs, which should be based on the latest available evidence. Future research should focus on measuring accurately age-specific RSV-attributable hospitalizations in very young children.

Original language	English
Pages (from-to)	1623-1631
Number of pages	9
Journal	Vaccine
Volume	41
Issue number	9
Early online date	22 Feb 2023
DOIs	https://doi.org/10.1016/j.vaccine.2023.01.058
Publication status	Published - 24 Feb 2023

Bibliographical note

Funding Information:
We would like to thank Anne Teirlinck, Michiel Van Boven and Pieter De Boer for providing advice and input data for the Netherlands, Richard Osei-Yeboah for his contribution in the time series analysis for Scotland, Rachel Reeves for advice on the multi-country RSV-ICD10 input data, Luca Stona for providing advice and input data for Veneto Region (Italy), John Paget and the entire team of the ComNet I study (https://www.nivel.nl/en/RSVComNet) for sharing results, Toni Lehtonen and Heini Salo for providing input data and advice for Finland. We would also like to thank Heini Salo, John Paget, Benoit Dervaux, Alexia Kieffer, and Florian Zeevat for their critical review and valuable comments.

Funding Information:
LW also gratefully acknowledged support from the Research Foundation Flanders (FWO) (postdoctoral fellowships 1234620N, 2019–2021). MJ was supported by the NIHR HPRU in Modelling and Health Economics (HPRU-2019-NIHR200908) and the NIHR HPRU in Immunisation (HPRU-2019-NIHR200929).

Funding Information:
Respiratory Syncytial Virus Consortium in Europe (RESCEU) has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement No 116019. This Joint Undertaking receives support from the European Union’s Horizon 2020 research and innovation programme and EFPIA.

Publisher Copyright:
© 2023 Elsevier Ltd

Data Availability Statement

Almost all the data analysed and generated during this study are included in this published article and its supplementary material files. Formal requests for additional data can be made to the co-responding author (XL) or the senior author (JB and PB).

Keywords

Cost-effectiveness analysis
Disease burden
Expected value of partial perfect information (EVPPI)
Expected value of perfect information (EVPI)
Maternal vaccine
Monoclonal antibody
Perspective
Respiratory syncytial virus (RSV)
Seasonal program

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.vaccine.2023.01.058

Cite this

@article{d5cdbe79fdc74ce6b087ecbbbb3d89c4,

title = "Cost-effectiveness of monoclonal antibody and maternal immunization against respiratory syncytial virus (RSV) in infants: Evaluation for six European countries",

abstract = "Background: Respiratory syncytial virus (RSV) imposes a substantial burden on pediatric hospital capacity in Europe. Promising prophylactic interventions against RSV including monoclonal antibodies (mAb) and maternal immunizations (MI) are close to licensure. Therefore, we aimed to evaluate the cost-effectiveness of potential mAb and MI interventions against RSV in infants, for six European countries. Methods: We used a static cohort model to compare costs and health effects of four intervention programs to no program and to each other: year-round MI, year-round mAb, seasonal mAb (October to April), and seasonal mAb plus a catch-up program in October. Input parameters were obtained from national registries and literature. Influential input parameters were identified with the expected value of partial perfect information and extensive scenario analyses (including the impact of interventions on wheezing and asthma). Results: From the health care payer perspective, and at a price of €50 per dose (mAb and MI), seasonal mAb plus catch-up was cost-saving in Scotland, and cost-effective for willingness-to-pay (WTP) values ≥€20,000 (England, Finland) or €30,000 (Denmark) per quality adjusted life-year (QALY) gained for all scenarios considered, except when using ICD-10 based hospitalization data. For the Netherlands, seasonal mAb was preferred (WTP value: €30,000-€90,000) for most scenarios. For Veneto region (Italy), either seasonal mAb with or without catch-up or MI was preferred, depending on the scenario and WTP value. From a full societal perspective (including leisure time lost), the seasonal mAb plus catch-up program was cost-saving for all countries except the Netherlands. Conclusion: The choice between a MI or mAb program depends on the level and duration of protection, price, availability, and feasibility of such programs, which should be based on the latest available evidence. Future research should focus on measuring accurately age-specific RSV-attributable hospitalizations in very young children.",

keywords = "Cost-effectiveness analysis, Disease burden, Expected value of partial perfect information (EVPPI), Expected value of perfect information (EVPI), Maternal vaccine, Monoclonal antibody, Perspective, Respiratory syncytial virus (RSV), Seasonal program",

author = "Getaneh, {Abraham M.} and Xiao Li and Zhuxin Mao and Johannesen, {Caroline K.} and Elisa Barbieri and {van Summeren}, Jojanneke and Xin Wang and Sabine Tong and Eugenio Baraldi and Emily Phijffer and Caterina Rizzo and {van Wijhe}, Maarten and Terho Heikkinen and Louis Bont and Lander Willem and Mark Jit and Philippe Beutels and Joke Bilcke and {Respiratory Syncytial Virus Consortium in Europe (RESCEU) investigators}",

note = "Funding Information: We would like to thank Anne Teirlinck, Michiel Van Boven and Pieter De Boer for providing advice and input data for the Netherlands, Richard Osei-Yeboah for his contribution in the time series analysis for Scotland, Rachel Reeves for advice on the multi-country RSV-ICD10 input data, Luca Stona for providing advice and input data for Veneto Region (Italy), John Paget and the entire team of the ComNet I study (https://www.nivel.nl/en/RSVComNet) for sharing results, Toni Lehtonen and Heini Salo for providing input data and advice for Finland. We would also like to thank Heini Salo, John Paget, Benoit Dervaux, Alexia Kieffer, and Florian Zeevat for their critical review and valuable comments. Funding Information: LW also gratefully acknowledged support from the Research Foundation Flanders (FWO) (postdoctoral fellowships 1234620N, 2019–2021). MJ was supported by the NIHR HPRU in Modelling and Health Economics (HPRU-2019-NIHR200908) and the NIHR HPRU in Immunisation (HPRU-2019-NIHR200929). Funding Information: Respiratory Syncytial Virus Consortium in Europe (RESCEU) has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement No 116019. This Joint Undertaking receives support from the European Union{\textquoteright}s Horizon 2020 research and innovation programme and EFPIA. Publisher Copyright: {\textcopyright} 2023 Elsevier Ltd",

year = "2023",

month = feb,

day = "24",

doi = "10.1016/j.vaccine.2023.01.058",

language = "English",

volume = "41",

pages = "1623--1631",

journal = "Vaccine",

issn = "0264-410X",

publisher = "Elsevier BV",

number = "9",

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TY - JOUR

T1 - Cost-effectiveness of monoclonal antibody and maternal immunization against respiratory syncytial virus (RSV) in infants

T2 - Evaluation for six European countries

AU - Getaneh, Abraham M.

AU - Li, Xiao

AU - Mao, Zhuxin

AU - Johannesen, Caroline K.

AU - Barbieri, Elisa

AU - van Summeren, Jojanneke

AU - Wang, Xin

AU - Tong, Sabine

AU - Baraldi, Eugenio

AU - Phijffer, Emily

AU - Rizzo, Caterina

AU - van Wijhe, Maarten

AU - Heikkinen, Terho

AU - Bont, Louis

AU - Willem, Lander

AU - Jit, Mark

AU - Beutels, Philippe

AU - Bilcke, Joke

AU - Respiratory Syncytial Virus Consortium in Europe (RESCEU) investigators

N1 - Funding Information: We would like to thank Anne Teirlinck, Michiel Van Boven and Pieter De Boer for providing advice and input data for the Netherlands, Richard Osei-Yeboah for his contribution in the time series analysis for Scotland, Rachel Reeves for advice on the multi-country RSV-ICD10 input data, Luca Stona for providing advice and input data for Veneto Region (Italy), John Paget and the entire team of the ComNet I study (https://www.nivel.nl/en/RSVComNet) for sharing results, Toni Lehtonen and Heini Salo for providing input data and advice for Finland. We would also like to thank Heini Salo, John Paget, Benoit Dervaux, Alexia Kieffer, and Florian Zeevat for their critical review and valuable comments. Funding Information: LW also gratefully acknowledged support from the Research Foundation Flanders (FWO) (postdoctoral fellowships 1234620N, 2019–2021). MJ was supported by the NIHR HPRU in Modelling and Health Economics (HPRU-2019-NIHR200908) and the NIHR HPRU in Immunisation (HPRU-2019-NIHR200929). Funding Information: Respiratory Syncytial Virus Consortium in Europe (RESCEU) has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement No 116019. This Joint Undertaking receives support from the European Union’s Horizon 2020 research and innovation programme and EFPIA. Publisher Copyright: © 2023 Elsevier Ltd

PY - 2023/2/24

Y1 - 2023/2/24

N2 - Background: Respiratory syncytial virus (RSV) imposes a substantial burden on pediatric hospital capacity in Europe. Promising prophylactic interventions against RSV including monoclonal antibodies (mAb) and maternal immunizations (MI) are close to licensure. Therefore, we aimed to evaluate the cost-effectiveness of potential mAb and MI interventions against RSV in infants, for six European countries. Methods: We used a static cohort model to compare costs and health effects of four intervention programs to no program and to each other: year-round MI, year-round mAb, seasonal mAb (October to April), and seasonal mAb plus a catch-up program in October. Input parameters were obtained from national registries and literature. Influential input parameters were identified with the expected value of partial perfect information and extensive scenario analyses (including the impact of interventions on wheezing and asthma). Results: From the health care payer perspective, and at a price of €50 per dose (mAb and MI), seasonal mAb plus catch-up was cost-saving in Scotland, and cost-effective for willingness-to-pay (WTP) values ≥€20,000 (England, Finland) or €30,000 (Denmark) per quality adjusted life-year (QALY) gained for all scenarios considered, except when using ICD-10 based hospitalization data. For the Netherlands, seasonal mAb was preferred (WTP value: €30,000-€90,000) for most scenarios. For Veneto region (Italy), either seasonal mAb with or without catch-up or MI was preferred, depending on the scenario and WTP value. From a full societal perspective (including leisure time lost), the seasonal mAb plus catch-up program was cost-saving for all countries except the Netherlands. Conclusion: The choice between a MI or mAb program depends on the level and duration of protection, price, availability, and feasibility of such programs, which should be based on the latest available evidence. Future research should focus on measuring accurately age-specific RSV-attributable hospitalizations in very young children.

AB - Background: Respiratory syncytial virus (RSV) imposes a substantial burden on pediatric hospital capacity in Europe. Promising prophylactic interventions against RSV including monoclonal antibodies (mAb) and maternal immunizations (MI) are close to licensure. Therefore, we aimed to evaluate the cost-effectiveness of potential mAb and MI interventions against RSV in infants, for six European countries. Methods: We used a static cohort model to compare costs and health effects of four intervention programs to no program and to each other: year-round MI, year-round mAb, seasonal mAb (October to April), and seasonal mAb plus a catch-up program in October. Input parameters were obtained from national registries and literature. Influential input parameters were identified with the expected value of partial perfect information and extensive scenario analyses (including the impact of interventions on wheezing and asthma). Results: From the health care payer perspective, and at a price of €50 per dose (mAb and MI), seasonal mAb plus catch-up was cost-saving in Scotland, and cost-effective for willingness-to-pay (WTP) values ≥€20,000 (England, Finland) or €30,000 (Denmark) per quality adjusted life-year (QALY) gained for all scenarios considered, except when using ICD-10 based hospitalization data. For the Netherlands, seasonal mAb was preferred (WTP value: €30,000-€90,000) for most scenarios. For Veneto region (Italy), either seasonal mAb with or without catch-up or MI was preferred, depending on the scenario and WTP value. From a full societal perspective (including leisure time lost), the seasonal mAb plus catch-up program was cost-saving for all countries except the Netherlands. Conclusion: The choice between a MI or mAb program depends on the level and duration of protection, price, availability, and feasibility of such programs, which should be based on the latest available evidence. Future research should focus on measuring accurately age-specific RSV-attributable hospitalizations in very young children.

KW - Cost-effectiveness analysis

KW - Disease burden

KW - Expected value of partial perfect information (EVPPI)

KW - Expected value of perfect information (EVPI)

KW - Maternal vaccine

KW - Monoclonal antibody

KW - Perspective

KW - Respiratory syncytial virus (RSV)

KW - Seasonal program

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U2 - 10.1016/j.vaccine.2023.01.058

DO - 10.1016/j.vaccine.2023.01.058

M3 - Article

C2 - 36737318

AN - SCOPUS:85147590318

SN - 0264-410X

VL - 41

SP - 1623

EP - 1631

JO - Vaccine

JF - Vaccine

IS - 9

ER -

Cost-effectiveness of monoclonal antibody and maternal immunization against respiratory syncytial virus (RSV) in infants: Evaluation for six European countries

Abstract

Bibliographical note

Data Availability Statement

Keywords

UN SDGs

Access to Document

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