Key result
In a decision model of the US birth cohort, nirsevimab was estimated to avert 364,204 RSV-LRTDs and save $1,289 million, providing greater impact than clesrovimab or RSVpreF versus standard care.
Why the study?
Three prophylactic interventions are approved in the US for infant RSV lower respiratory tract disease, but their comparative impact on events and costs versus the previous standard-of-practice had not been evaluated.
Do nirsevimab, clesrovimab, and RSVpreF reduce RSV-LRTD events and costs compared to palivizumab in the US birth cohort?
Do nirsevimab, clesrovimab, and RSVpreF reduce RSV-LRTD events and costs compared to palivizumab in the US birth cohort?
Nirsevimab is estimated to avert more RSV-LRTD events and associated medical costs in the US birth cohort compared to clesrovimab or RSVpreF maternal vaccination.
May support nirsevimab preference for US infant RSV prevention; leaves open real-world validation versus palivizumab.
BACKGROUND: In the U.S.A. three prophylactic interventions are approved for the prevention of respiratory syncytial virus (RSV) lower respiratory tract disease (LRTD) in infants: nirsevimab and clesrovimab (extended half-life monoclonal antibodies) and the maternal RSVpreF vaccine. We compared the impact of these interventions on RSV-LRTD events and costs versus the previous standard-of-practice (SoP; palivizumab-only strategy). RESEARCH DESIGN AND METHODS: Using a static decision-analytic model, we estimated the public health impact of nirsevimab, clesrovimab, and RSVpreF following the latest recommendations on RSV-related outcomes and costs in a US birth cohort during their first RSV season compared to the pre-2023 SoP. RESULTS: The model estimated that nirsevimab would avert 364,204 RSV-LRTDs including 32,404 hospitalizations, saving $1,289 million in direct and indirect costs. Depending on the assumed duration of protection, clesrovimab was estimated to avert 173,276-261,358 RSV-LRTDs of which 23,957-30,483 were hospitalizations, resulting in savings of $912-$1,150 million in total costs. RSVpreF maternal vaccination would avert 76,915 RSV-LRTDs including 9,649 hospitalizations, equating to $345 million in total cost savings. CONCLUSIONS: While all three interventions are estimated to reduce RSV-LRTD burden in infants, all-infant protection with nirsevimab was estimated to avert more events and associated medical costs for all infant subgroups compared to clesrovimab or RSVpreF.
No takes yet. Share an insight, caveat, or question.
Kieffer et al. (2025) studied respiratory syncytial virus (RSV) lower respiratory tract disease (LRTD). nirsevimab, clesrovimab, and RSVpreF vs. previous standard-of-practice (palivizumab-only strategy) was evaluated on RSV-LRTD events and costs. In a decision model of the US birth cohort, nirsevimab was estimated to avert 364,204 RSV-LRTDs and save $1,289 million, providing greater impact than clesrovimab or RSVpreF versus standard care.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: