Table 1 Cost-effectiveness studies included in the review
Income groupa | Setting | Author/year | Intervention(s) evaluated | Study objective | Key assumptions | Key measures and results |
|---|---|---|---|---|---|---|
UMIC | Argentina (ARG) | Farina et al. (2002) [26] | Short-acting mAb palivizumab (PVZ) | To evaluate the cost-effectiveness of PVZ given to premature infants (< 24 months old) with bronchopulmonary dysplasia (BPD) born in a hospital at < 35 weeks and < 28 weeks | Intervention cost: $656 Intervention efficacy: 55% Duration of protection: not reported (NR) Approach: Retrospective cohort study | Outcome measure: Incremental cost-effectiveness ratio (ICER) in USD ($)/hospitalisation averted Results: $15,538 |
UMIC | Argentina (ARG) | Rodriguez et al., (2008) [41] | PVZ | To perform a cost-effectiveness analysis on PVZ administration for the prevention of RSV-related hospitalisation rate in premature infants (< 24 months old) with and without BPD and with and without siblings in a hospital in Argentina | Intervention cost: $792 Intervention efficacy: 55% Duration of protection: NR Approach: Retrospective cohort study | Outcome measure: ICER $/hospitalisation averted Result: $10,456 among those without BPD and with siblings; $16,837 among those with BPD and with siblings; $34,088 among those with BPD and without siblings; $71,226 among those without BPD and without siblings |
UMIC | China (CHN) | Liu et al., (2021) [23] | Maternal immunisation (MI), long-acting mAb, paediatric immunisation (PI) | To evaluate the threshold strategy cost (TSC) of RSV interventions (the maximum cost per child for an intervention to be cost-effective) | Intervention cost: NR Intervention efficacy: MI 71.6%; mAb 100%; PI 100% waning to 70% by year 5 Duration of protection: MI 4Â months; mAb time-varying; PI time-varying Approach: Static cohort model | Outcome measure: TSC Result: Under willingness-to-pay of 1 GDP per capita per QALY gained, the TSC of RSV intervention ranged between $2.40 and $14.70 for MI; $19.90 and $144.20 for mAb; $28.70 and $201 for PI |
UMIC | Mexico (MEX) | Salinas-Escudero et al., (2012) [29] | PVZ | Evaluated the cost-effectiveness of PVZ prophylaxis for the reduction of RSV-associated complications in preterm patients (< 32 weeks and < 29 weeks) during RSV season in Mexico | Intervention cost: $661 Intervention efficacy: 55% Duration of protection: NR Approach: Decision tree model | Outcome measure: ICER $/QALY Result: $17,532 among preterm births < 29 weeks and $20,760 among preterm born 29–32 weeks |
UMIC | Turkey (TUR) | Oncel et al., (2012) [30] | PVZ | Evaluate the cost-effectiveness of RSV prophylaxis with PVZ in infants (< 24 months) from two hospitals in Turkey | Intervention cost: $516 Intervention efficacy: NR Duration of protection: NR Approach: Retrospective cohort study | Outcome measure: Average (mean) cost of treatment Result: $5019 for those treated with PVZ versus $1934 for those untreated |
UMIC | Turkey (TUR) | Pouwels et al., (2016) [31] | MI, PI | To evaluate the potential cost-effectiveness of RSV vaccination in infants and/or pregnant women in Turkey | Intervention cost: MI $13; PI $13 Intervention efficacy: MI 60%; PI 60% Duration of protection: MI 5Â months; PI 2Â years Approach: Multi-cohort static Markov model | Outcome measure: ICER $/QALY Result: MI TL 60,638; PI TL 51,969 |
UMIC | Malaysia (MYS) | Chan et al., (2003) [32] | PVZ | Determine the direct cost of resource utilisation in the treatment of children hospitalised with RSV chest infection and the potential cost savings with passive immunisation for high-risk infants | Intervention cost: $3360 Intervention efficacy: 55% Duration of protection: NR Approach: Retrospective cohort study | Outcome measure: ICER $/hospitalisation averted Result: $2921 |
Lower- middle-income country | Global (Gavi countries) | Li et al., (2020) [5] | MI, long-acting mAb | Use a country-specific model to evaluate the key drivers of the cost-effectiveness of maternal vaccination and infant mAb for 72 Gavi countries | Intervention cost: MI $3; mAb $6 Intervention efficacy: MI 75%; mAb 60% Duration of protection: MI 5Â months; mAb 6Â months Approach: Multi-country static cohort model | Outcome measure: ICER $/DALY Result: MI $1893; mAb $2769 |
Low- and middle-income countries | Global (low- and middle-income countries) | Baral et al., (2021) [28] | MI, long-acting mAb | Use a country-specific model, evaluate the potential impact and cost-effectiveness of two interventions to prevent childhood RSV—a maternal vaccine and a mAb | Intervention cost: MI $3.22; mAb $3.22 Intervention efficacy: MI 42%; mAb 70% Duration of protection: MI 6 months; mAb 6 months Approach: Static cohort model | Outcome measure: ICER $/DALY Result: MI: $1342; mAb: $431 |
LIC | Mali (MLI) | Laufer et al., (2021) [27] | PVZ, MI, long-acting mAb | Model the estimated likelihood of RSV preventive interventions being cost-effective in Mali | Intervention cost: PVZ NR; MI $1.38; mAb $1.38 Intervention efficacy: PVZ 55%; MI 56%; mAb 70% Duration of protection: PVZ 1mo; MI 3Â months; mAb 5Â months Approach: Decision tree model | Outcome measure: ICER $/DALY Result: PVZ $4280; MI $8020; mAb $1656 |