ArticleBMC medicine2023
Cost-effectiveness of pharmaceutical strategies to prevent respiratory syncytial virus disease in young children: a decision-support model for use in low-income and middle-income countries.
Article in BMC medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 3 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- RSV prophylactics for pediatric populations: A product review and meta-analysis of real-world effectiveness.Human vaccines & immunotherapeutics · 2026Pooled it
- Pooled it
- Global, regional, and national incidence and mortality burden of non-COVID-19 lower respiratory infections and aetiologies, 1990-2021: a systematic analysis from the Global Burden of Disease Study 2021.The Lancet. Infectious diseases · 2024Pooled it
- Nirsevimab for respiratory syncytial virus prevention: A comprehensive product review.Human vaccines & immunotherapeutics · 2026Review
- Circulation of Influenza and Other Respiratory Viruses in Tunisia, 2022-2023 Season.Influenza and other respiratory viruses · 2026Article
- Impact and cost-effectiveness of two interventions to prevent paediatric respiratory syncytial virus disease in Cameroon: a modelling approach.Journal of global health · 2026Article
- Evaluation of rotavirus, pneumococcal conjugate and human papillomavirus vaccination in four Pacific island countries: A cost-effectiveness modelling study.PLoS medicine · 2026Article
- Maternal RSV vaccination to protect infants in Brazil: a model-based cost-effectiveness analysis for incorporation into the National Immunisation Program.Lancet regional health. Americas · 2026Article
- Analysis of the economically justifiable price of nirsevimab to prevent respiratory syncytial virus infection in Korea.Human vaccines & immunotherapeutics · 2025Article
- Cost-effectiveness of introducing a maternal vaccine or long-acting monoclonal antibody to prevent infant respiratory syncytial virus disease in Nepal.Journal of global health · 2025Article
- Incidence of Respiratory Syncytial Virus-Associated Lower Respiratory Tract Infection Until 6 months of Corrected Age in Preterm Infants with Bronchopulmonary Dysplasia: A Pilot Prospective Cohort Study.Indian journal of pediatrics · 2025Article
- Cost-Effectiveness Analysis of Nirsevimab for Respiratory Syncytial Virus Disease Prevention in Newborns of Hong Kong.Influenza and other respiratory viruses · 2025Article
- Cost of respiratory syncytial virus hospitalisation in Brazilian infants: a micro-costing study from the perspective of a Brazilian tertiary public hospital, 2020-2023.BMC public health · 2025Article
- Systematic Review and Expert Consensus on the Use of Long-acting Monoclonal Antibodies for Prevention of Respiratory Syncytial Virus Disease: ARMADA (Advancing RSV Management And Disease Awareness) Taskforce.Open forum infectious diseases · 2025Review
- Article
- Cost-effectiveness analysis of the 13-valent pneumococcal conjugate vaccine administered to children under 5 years of age in the Republic of Moldova.Medicine and pharmacy reports · 2025Article
- Respiratory syncytial virus: health burden, disease prevention, and treatment-recent progress and lessons learned.microLife · 2025Review
- Cost-effectiveness of respiratory syncytial virus prevention strategies in Mozambique: a modelling study.Journal of global health economics and policy · 2025Article
- Article
- Characteristics of inpatient and outpatient respiratory syncytial virus mortality in Gavi-eligible countries.Vaccine: X · 2024Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRespiratory syncytial virus (RSV) is a leading cause of respiratory disease in young children. A number of mathematical models have been used to assess the cost-effectiveness of RSV prevention strategies, but these have not been designed for ease of use by multidisciplinary teams working in low-income and middle-income countries (LMICs).
methodsWe describe the UNIVAC decision-support model (a proportionate outcomes static cohort model) and its approach to exploring the potential cost-effectiveness of two RSV prevention strategies: a single-dose maternal vaccine and a single-dose long-lasting monoclonal antibody (mAb) for infants. We identified model input parameters for 133 LMICs using evidence from the literature and selected national datasets. We calculated the potential cost-effectiveness of each RSV prevention strategy (compared to nothing and to each other) over the lifetimes of all children born in the year 2025 and compared our results to a separate model published by PATH. We ran sensitivity and scenario analyses to identify the inputs with the largest influence on the cost-effectiveness results.
resultsOur illustrative results assuming base case input assumptions for maternal vaccination ($3.50 per dose, 69% efficacy, 6 months protection) and infant mAb ($3.50 per dose, 77% efficacy, 5 months protection) showed that both interventions were cost-saving compared to status quo in around one-third of 133 LMICs, and had a cost per DALY averted below 0.5 times the national GDP per capita in the remaining LMICs. UNIVAC generated similar results to a separate model published by PATH. Cost-effectiveness results were most sensitive to changes in the price, efficacy and duration of protection of each strategy, and the rate (and cost) of RSV hospital admissions.
conclusionsForthcoming RSV interventions (maternal vaccines and infant mAbs) are worth serious consideration in LMICs, but there is a good deal of uncertainty around several influential inputs, including intervention price, efficacy, and duration of protection. The UNIVAC decision-support model provides a framework for country teams to build consensus on data inputs, explore scenarios, and strengthen the local ownership and policy-relevance of results.
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