Work

Modeling the potential clinical and economic impact of clesrovimab for the prevention of RSV in infants in England and Wales

Year: 2026

Type: article

Abstract: Background: Respiratory syncytial virus (RSV) infects nearly all children under two years, causing mild lower respiratory tract infections (LRTIs) although serious disease, mortality and long-term recurrent wheezing can also occur. Objectives: This study evaluates the health and economic impact of various RSV prevention strategies (monoclonal antibodies [mAb] such as clesrovimab, nirsevimab, palivizumab [high risk infants only] or maternal vaccination) in infants in England and Wales. Design: A previously published decision tree model was adapted to estimate RSV LRTIs and associated costs over one year among a cohort of infants entering their first RSV season in England and Wales. Methods: Clinical trial data were used for efficacy inputs alongside country-specific epidemiology and costs to assess the impact of year-round and seasonal mAb programs (without and with catch-up [for infants born out of season]) alongside maternal vaccination. Deterministic sensitivity analyses of incremental treatment costs and QALYs were performed. Results: Seasonal administration of clesrovimab with and without catch-up led to fewer RSV-associated LRTI cases and lower treatment costs compared to other RSV intervention strategies. Without catch-up, clesrovimab reduced RSV-LRTI cases by 18%-27% versus palivizumab, 3%-4% versus nirsevimab and 2%-13% versus maternal vaccine. With catch-up, RSV-LRTI outcomes reductions by clesrovimab were greater: 60%-70% versus palivizumab, 14%-20% versus nirsevimab, and 43%-54% versus maternal vaccination. It also reduced treatment costs by £37.0 million compared to palivizumab, £4.0 million compared to nirsevimab, and £26.0 million compared to maternal vaccination. Coverage and efficacies were the most influential parameters. Conclusions: Clesrovimab is projected to substantially reduce RSV-associated clinical outcomes and costs compared to both standard of care and potential new RSV prevention measures in England and Wales.

Source: Therapeutic Advances in Infectious Disease

DOI: 10.1177/20499361261483967