The impact of nirsevimab prophylaxis on RSV hospitalizations: a real-world cost-benefit analysis in Tuscany, Italy
BackgroundRespiratory Syncytial Virus (RSV) is the leading cause of hospitalizations in infants. The approval of nirsevimab, a long-acting monoclonal antibody, has extended the potential for RSV prophylaxis to all infants. This study assesses the cost–benefit of various Nirsevimab prophylaxis strate...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-07-01
|
| Series: | Frontiers in Public Health |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2025.1604331/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850106658551758848 |
|---|---|
| author | Vieri Lastrucci Martina Pacifici Giorgia Alderotti Monia Puglia Elettra Berti Federica Barbati Lorenzo Lodi Lorenzo Lodi Silvia Boscia Francesco Nieddu Giuseppe Indolfi Giuseppe Indolfi Diego Peroni Marco Martini Chiara Azzari Chiara Azzari Fabio Voller Maria Moriondo Silvia Ricci Silvia Ricci |
| author_facet | Vieri Lastrucci Martina Pacifici Giorgia Alderotti Monia Puglia Elettra Berti Federica Barbati Lorenzo Lodi Lorenzo Lodi Silvia Boscia Francesco Nieddu Giuseppe Indolfi Giuseppe Indolfi Diego Peroni Marco Martini Chiara Azzari Chiara Azzari Fabio Voller Maria Moriondo Silvia Ricci Silvia Ricci |
| author_sort | Vieri Lastrucci |
| collection | DOAJ |
| description | BackgroundRespiratory Syncytial Virus (RSV) is the leading cause of hospitalizations in infants. The approval of nirsevimab, a long-acting monoclonal antibody, has extended the potential for RSV prophylaxis to all infants. This study assesses the cost–benefit of various Nirsevimab prophylaxis strategies for infants during their first RSV season in preventing RSV-associated hospitalization in the Tuscany region, Italy.MethodsThe analysis was conducted from the perspective of the healthcare payor. Real-world data from the Tuscany birth cohort (N = 21,017) experiencing their first RSV season in the 2023/2024 season were used to calculate the net benefit and benefit cost ratio (BCR) of three possible nirsevimab prophylaxis strategies compared with prophylaxis practices at the time of the study, which includes the use of palivizumab in eligible infants. RSV-associated hospitalizations and severe hospitalizations were considered as health outcomes. Sensitivity analyses were performed to identify influential variables.ResultsUnder prophylaxis practices at the time of the study, there were a total of 663 hospitalizations associated with RSV, including 102 severe cases, representing €5,247,645 in costs. An extended prophylaxis strategy with nirsevimab, including all infants born both before and during the RSV season, resulted in the highest number of hospitalizations avoided (378), with a BCR close to break-even (0.96). A seasonal-only strategy targeting infants born during the season prevented the fewest hospitalizations (252), showing a positive BCR of 1.15. Finally, a seasonal strategy with targeted catch-up, including also preterm infants born before the season, yielded the highest cost–benefit ratio (1.56), preventing 270 hospitalizations.ConclusionUniversal prophylaxis strategies with nirsevimab, targeting all infants during their first RSV epidemic season, substantially reduce hospitalization burdens without increasing economic pressure on the healthcare system. Although alternative strategies are more cost-effective, they prevent fewer hospitalizations, emphasizing the public health value of broader prophylaxis approaches. |
| format | Article |
| id | doaj-art-a9acbf5ab2b84569804a35d2a20a02f6 |
| institution | OA Journals |
| issn | 2296-2565 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj-art-a9acbf5ab2b84569804a35d2a20a02f62025-08-20T02:38:46ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-07-011310.3389/fpubh.2025.16043311604331The impact of nirsevimab prophylaxis on RSV hospitalizations: a real-world cost-benefit analysis in Tuscany, ItalyVieri Lastrucci0Martina Pacifici1Giorgia Alderotti2Monia Puglia3Elettra Berti4Federica Barbati5Lorenzo Lodi6Lorenzo Lodi7Silvia Boscia8Francesco Nieddu9Giuseppe Indolfi10Giuseppe Indolfi11Diego Peroni12Marco Martini13Chiara Azzari14Chiara Azzari15Fabio Voller16Maria Moriondo17Silvia Ricci18Silvia Ricci19Epidemiology Unit, Meyer Children’s Hospital IRCCS, Florence, ItalyEpidemiologic Observatory, Regional Healthcare Agency of Tuscany, Florence, ItalyEpidemiology Unit, Meyer Children’s Hospital IRCCS, Florence, ItalyEpidemiologic Observatory, Regional Healthcare Agency of Tuscany, Florence, ItalyNeonatal Intensive Care Unit, Meyer Children’s Hospital IRCCS, Florence, ItalyPediatrics and Neonatology Unit, Santo Stefano Hospital, USL Toscana Centro, Prato, ItalyDepartment of Neurofarba, University of Florence, Florence, ItalyImmunology Unit, Meyer Children’s Hospital IRCCS, Florence, ItalyImmunology Unit, Meyer Children’s Hospital IRCCS, Florence, ItalyImmunology Unit, Meyer Children’s Hospital IRCCS, Florence, ItalyDepartment of Neurofarba, University of Florence, Florence, ItalyPediatric and Liver Unit, Meyer Children’s Hospital IRCCS, Florence, ItalyPediatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, ItalyPediatric Unit, San Donato Hospital, Arezzo, ItalyImmunology Unit, Meyer Children’s Hospital IRCCS, Florence, Italy0Department of Health Sciences, University of Florence, Florence, ItalyEpidemiologic Observatory, Regional Healthcare Agency of Tuscany, Florence, ItalyImmunology Unit, Meyer Children’s Hospital IRCCS, Florence, ItalyImmunology Unit, Meyer Children’s Hospital IRCCS, Florence, Italy0Department of Health Sciences, University of Florence, Florence, ItalyBackgroundRespiratory Syncytial Virus (RSV) is the leading cause of hospitalizations in infants. The approval of nirsevimab, a long-acting monoclonal antibody, has extended the potential for RSV prophylaxis to all infants. This study assesses the cost–benefit of various Nirsevimab prophylaxis strategies for infants during their first RSV season in preventing RSV-associated hospitalization in the Tuscany region, Italy.MethodsThe analysis was conducted from the perspective of the healthcare payor. Real-world data from the Tuscany birth cohort (N = 21,017) experiencing their first RSV season in the 2023/2024 season were used to calculate the net benefit and benefit cost ratio (BCR) of three possible nirsevimab prophylaxis strategies compared with prophylaxis practices at the time of the study, which includes the use of palivizumab in eligible infants. RSV-associated hospitalizations and severe hospitalizations were considered as health outcomes. Sensitivity analyses were performed to identify influential variables.ResultsUnder prophylaxis practices at the time of the study, there were a total of 663 hospitalizations associated with RSV, including 102 severe cases, representing €5,247,645 in costs. An extended prophylaxis strategy with nirsevimab, including all infants born both before and during the RSV season, resulted in the highest number of hospitalizations avoided (378), with a BCR close to break-even (0.96). A seasonal-only strategy targeting infants born during the season prevented the fewest hospitalizations (252), showing a positive BCR of 1.15. Finally, a seasonal strategy with targeted catch-up, including also preterm infants born before the season, yielded the highest cost–benefit ratio (1.56), preventing 270 hospitalizations.ConclusionUniversal prophylaxis strategies with nirsevimab, targeting all infants during their first RSV epidemic season, substantially reduce hospitalization burdens without increasing economic pressure on the healthcare system. Although alternative strategies are more cost-effective, they prevent fewer hospitalizations, emphasizing the public health value of broader prophylaxis approaches.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1604331/fullrespiratory syncytial virus (RSV)immunizationpreventionnirsevimabhospitalizationscost–benefit analysis |
| spellingShingle | Vieri Lastrucci Martina Pacifici Giorgia Alderotti Monia Puglia Elettra Berti Federica Barbati Lorenzo Lodi Lorenzo Lodi Silvia Boscia Francesco Nieddu Giuseppe Indolfi Giuseppe Indolfi Diego Peroni Marco Martini Chiara Azzari Chiara Azzari Fabio Voller Maria Moriondo Silvia Ricci Silvia Ricci The impact of nirsevimab prophylaxis on RSV hospitalizations: a real-world cost-benefit analysis in Tuscany, Italy Frontiers in Public Health respiratory syncytial virus (RSV) immunization prevention nirsevimab hospitalizations cost–benefit analysis |
| title | The impact of nirsevimab prophylaxis on RSV hospitalizations: a real-world cost-benefit analysis in Tuscany, Italy |
| title_full | The impact of nirsevimab prophylaxis on RSV hospitalizations: a real-world cost-benefit analysis in Tuscany, Italy |
| title_fullStr | The impact of nirsevimab prophylaxis on RSV hospitalizations: a real-world cost-benefit analysis in Tuscany, Italy |
| title_full_unstemmed | The impact of nirsevimab prophylaxis on RSV hospitalizations: a real-world cost-benefit analysis in Tuscany, Italy |
| title_short | The impact of nirsevimab prophylaxis on RSV hospitalizations: a real-world cost-benefit analysis in Tuscany, Italy |
| title_sort | impact of nirsevimab prophylaxis on rsv hospitalizations a real world cost benefit analysis in tuscany italy |
| topic | respiratory syncytial virus (RSV) immunization prevention nirsevimab hospitalizations cost–benefit analysis |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2025.1604331/full |
| work_keys_str_mv | AT vierilastrucci theimpactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT martinapacifici theimpactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT giorgiaalderotti theimpactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT moniapuglia theimpactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT elettraberti theimpactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT federicabarbati theimpactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT lorenzolodi theimpactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT lorenzolodi theimpactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT silviaboscia theimpactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT francesconieddu theimpactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT giuseppeindolfi theimpactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT giuseppeindolfi theimpactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT diegoperoni theimpactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT marcomartini theimpactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT chiaraazzari theimpactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT chiaraazzari theimpactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT fabiovoller theimpactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT mariamoriondo theimpactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT silviaricci theimpactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT silviaricci theimpactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT vierilastrucci impactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT martinapacifici impactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT giorgiaalderotti impactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT moniapuglia impactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT elettraberti impactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT federicabarbati impactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT lorenzolodi impactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT lorenzolodi impactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT silviaboscia impactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT francesconieddu impactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT giuseppeindolfi impactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT giuseppeindolfi impactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT diegoperoni impactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT marcomartini impactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT chiaraazzari impactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT chiaraazzari impactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT fabiovoller impactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT mariamoriondo impactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT silviaricci impactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly AT silviaricci impactofnirsevimabprophylaxisonrsvhospitalizationsarealworldcostbenefitanalysisintuscanyitaly |