Optimal Respiratory Syncytial Virus intervention programmes using Nirsevimab in England and Wales

David Hodgson, Mihaly Koltai, Fabienne Krauer, Stefan Flasche, Mark Jit, Katherine E Atkins

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

INTRODUCTION: Respiratory Syncytial Virus (RSV) is a major cause of acute lower respiratory tract infections (ALRI) in infants. There are no licensed vaccines and only one monoclonal antibody available to protect infants from disease. A new and potentially longer-lasting monoclonal antibody, Nirsevimab, showed promising results in phase IIb/III trials. We evaluate the cost-effectiveness of Nirsevimab intervention programmes in England and Wales.

METHODS: We used a dynamic model for RSV transmission, calibrated to data from England and Wales. We considered a suite of potential Nirsevimab programmes, including administration to all neonates (year-round); only neonates born during the RSV season (seasonal); or neonates born during the RSV season plus infants less than six months old before the start of the RSV season (seasonal + catch-up).

RESULTS: If administered seasonally to all infants at birth, we found that Nirsevimab would have to be priced at £63 or less per dose for at least 50% certainty that it could cost-effectively replace the current Palivizumab programme, using an ICER threshold of £20,000/QALY. An extended seasonal programme which includes a pre-season catch-up becomes the optimal strategy at a purchasing price of £32/dose or less for at least 50% certainty. At a purchasing price per dose of £5-32, the annual implementation costs of a seasonal programme could be as high as £2 million before a switch to a year-round strategy would be optimal.

DISCUSSION: Nirsevimab has the potential to be cost-effective in England and Wales not only for use in high-risk infants.

Original languageEnglish
Pages (from-to)7151-7157
Number of pages7
Issue number49
Early online date31 Oct 2022
Publication statusPublished - 22 Nov 2022

Keywords / Materials (for Non-textual outputs)

  • Cost-effectiveness analysis
  • Economic model
  • Monoclonal antibodies
  • RSV


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