阿根廷孕期接种二价呼吸道合胞病毒预混 F (RSVpreF) 疫苗预防婴儿感染呼吸道合胞病毒的成本效益。

IF 4.7 3区 医学 Q1 INFECTIOUS DISEASES Infectious Diseases and Therapy Pub Date : 2024-11-01 Epub Date: 2024-10-04 DOI:10.1007/s40121-024-01055-5
Lucila Rey-Ares, Ahuva Averin, Nadia Zuccarino, Celina Guadalupe Vega, Emily Kutrieb, Erin Quinn, Mark Atwood, Derek Weycker, Amy W Law
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引用次数: 0

摘要

导言:在阿根廷,由呼吸道合胞病毒(RSV)引起的下呼吸道疾病(LRTI)在幼儿中很常见。目前可用的预防药物仅限于年龄小于 2 岁且患有特定高风险疾病的儿童使用,因此大多数婴儿仍未得到保护。我们估算了孕妇使用新型 RSVpreF 疫苗预防婴儿出生后第一年 RSV-LRTI 的价值基础价格(VBP):方法: 使用基于人群的马尔可夫型队列模型预测了婴儿期 RSV-LRTI 的临床结果和经济成本,以及孕期接种 RSVpreF 疫苗的预期影响。模型结果根据出生时的胎龄、疾病/死亡率和母亲的疫苗接种情况进行估计,包括 RSV-LRTI 病例总数、RSV-LRTI 相关死亡人数和相关成本。从医疗保健系统的角度进行了基础病例分析(接种 RSVpreF 与不接种疫苗)。还进行了概率敏感性分析(PSA;1000 次重复)。在基础案例分析和 PSA 中,支付意愿(WTP)为每质量调整生命年(QALY;即 1 × 2021 年人均国内生产总值 [GDP])10,636 美元。成本以美元为单位,根据 2023 年 6 月 22 日的汇率估算:结果:342,110 名孕妇使用 RSVpreF 为 330,079 名出生婴儿提供了保护。RSVpreF 共预防了 3915 例 RSV 住院病例、6399 例 RSV 急诊病例、6182 例 RSV 门诊病例和 67 例与疾病相关的死亡病例。预计直接成本将减少 500 万美元。由于获得了 2061 个 QALY,疫苗管理成本为 140 万美元,RSVpreF 的 VBP 估计为每剂 74.46 美元。在 PSA 中,平均 VBP 为 75.02 美元(95% 置信区间为 54.24-97.30):在阿根廷,孕妇使用 RSVpreF 可显著减轻婴儿 RSV-LRTI 的临床和经济负担,在价格不超过 75 美元的情况下,RSVpreF 被认为是一种具有成本效益的干预措施。
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Cost-Effectiveness of Bivalent Respiratory Syncytial Virus Prefusion F (RSVpreF) Vaccine During Pregnancy for Prevention of Respiratory Syncytial Virus Among Infants in Argentina.

Introduction: Lower respiratory tract illness (LRTI) caused by respiratory syncytial virus (RSV) is common among young children in Argentina. Use of the currently available prophylactic agent is limited to children aged ≤ 2 years with selected high-risk conditions, and thus the majority of infants remain unprotected. We estimated the value-based price (VBP) of a novel RSVpreF vaccine for use among pregnant people for prevention of RSV-LRTI among infants during the first year of life.

Methods: Clinical outcomes and economic costs of RSV-LRTI during infancy and expected impact of RSVpreF vaccination during pregnancy were projected using a population-based Markov-type cohort model. Model results-estimated on the basis of gestational age at birth, disease/fatality rates, and mother's vaccination status-include total numbers of RSV-LRTI cases, RSV-LRTI-related deaths, and associated costs. Base case analyses (RSVpreF vs. no vaccine) were conducted from the healthcare system perspective. Probabilistic sensitivity analyses (PSA; 1000 replications) were also conducted. Willingness-to-pay (WTP) was $10,636 per quality-adjusted life-year (QALY; i.e., 1 × 2021 gross domestic product [GDP] per capita) in base case analyses and PSA. Costs are reported in USD, estimated on the basis of the June 22, 2023 exchange rate.

Results: Use of RSVpreF among 342,110 pregnant persons provided protection to 330,079 infants at birth. In total, RSVpreF prevented 3915 RSV hospitalizations, 6399 RSV cases requiring emergency department care, 6182 RSV cases requiring a physician office visit, and 67 disease-related deaths. Direct costs were projected to be reduced by $5.0 million. With 2061 QALYs gained and vaccine administration cost of $1.4 million, the VBP of RSVpreF was estimated to be $74.46 per dose. In PSA, mean VBP was $75.02 (95% confidence interval 54.24-97.30).

Conclusions: RSVpreF among pregnant persons would significantly reduce the clinical and economic burden of RSV-LRTI among infants in Argentina and would be considered a cost-effective intervention up to a price of approximately $75.

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来源期刊
Infectious Diseases and Therapy
Infectious Diseases and Therapy Medicine-Microbiology (medical)
CiteScore
8.60
自引率
1.90%
发文量
136
审稿时长
6 weeks
期刊介绍: Infectious Diseases and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of infectious disease therapies and interventions, including vaccines and devices. Studies relating to diagnostic products and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, bacterial and fungal infections, viral infections (including HIV/AIDS and hepatitis), parasitological diseases, tuberculosis and other mycobacterial diseases, vaccinations and other interventions, and drug-resistance, chronic infections, epidemiology and tropical, emergent, pediatric, dermal and sexually-transmitted diseases.
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