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Background <p>Two immunising products are emerging to prevent the burden of respiratory syncytial virus (RSV) in infants: long-lasting monoclonal antibodies (mAbs) and maternal vaccines given during pregnancy (MV). This study assesses the potential cost-effectiveness of programs involving each product to help inform policy decisions related to their implementation in the Australian context.</p> Methods <p>We developed an individual-based dynamic transmission model of RSV infection, linked to a clinical pathways model and cost-effectiveness model. We modelled key scenarios exploring varying eligibility and coverage of immunisation products for at-risk and not-at-risk populations, in addition to sensitivity analyses of immunisation characteristics, program costs and the impact of potential under-ascertainment of RSV burden. We estimated the cost-effectiveness of each program from a health system perspective, with results presented as incremental cost-effectiveness ratios in terms of cost per quality-adjusted life year gained (QALY).</p> Results <p>We found a combined program in which administration of MV during pregnancy is supplemented with a birth-dose of mAbs for newborns born without protection from MV is likely to be cost-saving, compared with the status quo of no MV or mAbs delivered. This program averted on average 41% of infant hospitalisations per year and reduced QALY losses by 33%.</p> Conclusions <p>Programs combining infant immunisation products are likely to significantly reduce the burden of RSV disease in Australia, and be cost-saving. However, their estimated impact and cost-effectiveness is strongly dependent on key assumptions (i) the consistency and completeness of ascertainment of disease burden over time; (ii) the cost of a hospitalisation and immunising dose; (iii) the efficacy and durability of protection of the modelled products; and (iv) the timing and coverage of the immunisation delivery.</p>

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Cost-Effectiveness of Immunising Interventions to Reduce Respiratory Syncytial Virus Disease Burden in Infants in Australia

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月7日

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  • Julian B. Carlin,
  • Adrian J. Marcato,
  • Yingying Wang,
  • Robert Moss,
  • Kylie S. Carville,
  • Xinghui Chen,
  • Victoria L. Oliver,
  • Violeta Spirkoska,
  • Patricia T. Campbell,
  • David J. Price,
  • Natalie Carvalho,
  • Jodie McVernon

摘要

Background

Two immunising products are emerging to prevent the burden of respiratory syncytial virus (RSV) in infants: long-lasting monoclonal antibodies (mAbs) and maternal vaccines given during pregnancy (MV). This study assesses the potential cost-effectiveness of programs involving each product to help inform policy decisions related to their implementation in the Australian context.

Methods

We developed an individual-based dynamic transmission model of RSV infection, linked to a clinical pathways model and cost-effectiveness model. We modelled key scenarios exploring varying eligibility and coverage of immunisation products for at-risk and not-at-risk populations, in addition to sensitivity analyses of immunisation characteristics, program costs and the impact of potential under-ascertainment of RSV burden. We estimated the cost-effectiveness of each program from a health system perspective, with results presented as incremental cost-effectiveness ratios in terms of cost per quality-adjusted life year gained (QALY).

Results

We found a combined program in which administration of MV during pregnancy is supplemented with a birth-dose of mAbs for newborns born without protection from MV is likely to be cost-saving, compared with the status quo of no MV or mAbs delivered. This program averted on average 41% of infant hospitalisations per year and reduced QALY losses by 33%.

Conclusions

Programs combining infant immunisation products are likely to significantly reduce the burden of RSV disease in Australia, and be cost-saving. However, their estimated impact and cost-effectiveness is strongly dependent on key assumptions (i) the consistency and completeness of ascertainment of disease burden over time; (ii) the cost of a hospitalisation and immunising dose; (iii) the efficacy and durability of protection of the modelled products; and (iv) the timing and coverage of the immunisation delivery.