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Background <p>Some immunosuppressive disorders have shown substantially lower protection after COVID-19 vaccination against severe outcomes. Therefore, pre-exposure prophylaxis is proposed. Targeted immunotherapy with monoclonal antibodies represents an option for preventing severe COVID-19. However, there is a lack of epidemiological and economic information on pre-exposure prophylaxis with targeted immunotherapies against COVID-19 among immunosuppressed patients. Thus, this study aims to identify and estimate the size of target population and direct medical costs related to pre-exposure prophylaxis with targeted immunotherapies against COVID-19 among the immunosuppressed adult population, and to explore the short-term economic impact of introducing tixagevimab–cilgavimab (AZD7442) for pre-exposure prophylaxis from the social security perspective in Argentina. This perspective was chosen due to the broad coverage of Argentina’s social security system, ensuring a representative framework for cost and access analysis.</p> Methods <p>Through a four-step approach, we: 1) identified the immunosuppressed adult potential target population that could be eligible for pre-exposure prophylaxis with targeted immunotherapies in Argentina; 2) estimated direct medical costs associated with pre-exposure prophylaxis and COVID-19 management using a micro-costing approach; and 3) explore a cost analysis for the case of tixagevimab–cilgavimab 600 mg (assuming an ex-factory price of $950 per pack) from the social security perspective in Argentina, considering 0% and 100% pre-exposure prophylaxis uptake scenarios. Costs were expressed in American dollars ($) as of November 2022 (exchange rate: 130.8 Argentinian pesos = 1 American dollar).</p> Results <p>We estimated that 12,788 patients with target conditions (approximately 40 per 100,000 adults) would be candidates for receiving this therapy in Argentina. In terms of costs, the 100% uptake scenario accounts for total annual savings of approximately $ 121,902.7 in outpatient and hospitalization COVID-19-related costs. Also, tixagevimab–cilgavimab acquisition and administration costs represented an annual incremental cost of $24,415,617 ($1,918.5 per patient year). Finally, the net cost difference between the 100% and 0% uptake scenarios were estimated at $24,254,732.3 ($1,896.6 per patient year).</p> Conclusion <p>This study provides crucial information for local and regional decision-makers to guide informed assessment of a potential coverage of pre-exposure prophylaxis with targeted immunotherapy among the immunosuppressed population.</p>

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Epidemiological and economic impact of pre-exposure prophylaxis with targeted immunotherapies for COVID-19 among immunosuppressed patients in Argentina

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月21日

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  • Carolina Moreno-López,
  • Federico Rodríguez Cairoli,
  • Rosario Luxardo,
  • Federico Augustovski,
  • Natalia Espinola

摘要

Background

Some immunosuppressive disorders have shown substantially lower protection after COVID-19 vaccination against severe outcomes. Therefore, pre-exposure prophylaxis is proposed. Targeted immunotherapy with monoclonal antibodies represents an option for preventing severe COVID-19. However, there is a lack of epidemiological and economic information on pre-exposure prophylaxis with targeted immunotherapies against COVID-19 among immunosuppressed patients. Thus, this study aims to identify and estimate the size of target population and direct medical costs related to pre-exposure prophylaxis with targeted immunotherapies against COVID-19 among the immunosuppressed adult population, and to explore the short-term economic impact of introducing tixagevimab–cilgavimab (AZD7442) for pre-exposure prophylaxis from the social security perspective in Argentina. This perspective was chosen due to the broad coverage of Argentina’s social security system, ensuring a representative framework for cost and access analysis.

Methods

Through a four-step approach, we: 1) identified the immunosuppressed adult potential target population that could be eligible for pre-exposure prophylaxis with targeted immunotherapies in Argentina; 2) estimated direct medical costs associated with pre-exposure prophylaxis and COVID-19 management using a micro-costing approach; and 3) explore a cost analysis for the case of tixagevimab–cilgavimab 600 mg (assuming an ex-factory price of $950 per pack) from the social security perspective in Argentina, considering 0% and 100% pre-exposure prophylaxis uptake scenarios. Costs were expressed in American dollars ($) as of November 2022 (exchange rate: 130.8 Argentinian pesos = 1 American dollar).

Results

We estimated that 12,788 patients with target conditions (approximately 40 per 100,000 adults) would be candidates for receiving this therapy in Argentina. In terms of costs, the 100% uptake scenario accounts for total annual savings of approximately $ 121,902.7 in outpatient and hospitalization COVID-19-related costs. Also, tixagevimab–cilgavimab acquisition and administration costs represented an annual incremental cost of $24,415,617 ($1,918.5 per patient year). Finally, the net cost difference between the 100% and 0% uptake scenarios were estimated at $24,254,732.3 ($1,896.6 per patient year).

Conclusion

This study provides crucial information for local and regional decision-makers to guide informed assessment of a potential coverage of pre-exposure prophylaxis with targeted immunotherapy among the immunosuppressed population.