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Peer-reviewedCC BY-NC 4.0Therapeutic Advances in Infectious Disease

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

  • Klodeta Kura1
  • Colleen Burgess2
  • Ian R. Matthews3
  • Salisu M. Garba2
  • Dawei Wang2
  • John C. Lang4
  • Dionysios Ntais3
  • Yao-Hsuan Chen1
4 affiliations
  1. 1Health Economic and Decision Sciences, MSD (UK) Ltd., London, UK
  2. 2Health Economic and Decision Sciences, Merck & Co., Inc., Rahway, USA
  3. 3Value, Access, and Devolved Nations (VAD), MSD (UK) Ltd., London, UK
  4. 4Health Economic and Decision Sciences, Merck Canada Inc, Kirkland, QC, Canada
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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.

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Cite

BibTeXRIS
BibTeX
@article{kura2026modeling,
  title = {{Modeling the potential clinical and economic impact of clesrovimab for the prevention of RSV in infants in England and Wales}},
  author = {Klodeta Kura and Colleen Burgess and Ian R. Matthews and Salisu M. Garba and Dawei Wang and John C. Lang and Dionysios Ntais and Yao-Hsuan Chen},
  journal = {Therapeutic Advances in Infectious Disease},
  year = {2026},
  month = sep,
  doi = {10.1177/20499361261483967},
  url = {https://doi.org/10.1177/20499361261483967},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Modeling the potential clinical and economic impact of clesrovimab for the prevention of RSV in infants in England and Wales
AU  - Klodeta Kura
AU  - Colleen Burgess
AU  - Ian R. Matthews
AU  - Salisu M. Garba
AU  - Dawei Wang
AU  - John C. Lang
AU  - Dionysios Ntais
AU  - Yao-Hsuan Chen
PY  - 2026
DA  - 2026/09/17
JO  - Therapeutic Advances in Infectious Disease
DO  - 10.1177/20499361261483967
UR  - https://doi.org/10.1177/20499361261483967
AB  - 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.
SN  - 2049-9361
SN  - 2049-937X
ER  -