Is National Support for RSV Immunization Cost-Effective?

Pfizer's Maternal Vaccine Joins Sanofi and MSD
Preventive Injections Available, But Fully Self-Funded

Options for preventing respiratory syncytial virus (RSV) infection in infants and young children are expanding. In addition to the introduction of two types of long-acting prophylactic antibodies administered directly to infants, a vaccine for pregnant women has also been launched. As the methods of prevention are diversifying, there is increasing discussion about the need to consider not only efficacy but also factors such as cost, target recipients, and the impact on healthcare expenditures.

According to industry sources on August 27, two types of long-acting RSV prophylactic antibodies for infants—Sanofi·AstraZeneca's “Beyfortus (nirsevimab)” and “Enfloncia (clessrovimab)” from MSD Korea—are currently competing in the domestic market. Pfizer's RSV vaccine “Abrysvo” has also become an option through its administration to pregnant women to protect infants. While Beyfortus and Enfloncia involve administering fully developed antibodies directly to infants, Abrysvo works by vaccinating pregnant women, enabling them to pass on protective antibodies to the fetus.

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RSV is a common acute respiratory virus among infants and young children, with most children becoming infected at least once before the age of two. In most cases, infection presents with cold-like symptoms, but in relatively younger infants or those in high-risk groups, it can progress to lower respiratory tract infections such as bronchiolitis and pneumonia, sometimes requiring hospitalization. Particularly during the early months of life, infants have narrower airways and underdeveloped immune systems, leaving them more vulnerable to severe disease caused by RSV infection.

The World Health Organization (WHO) recommends the introduction of maternal vaccines or long-acting monoclonal antibodies for infant RSV prevention, advising countries to also consider cost-effectiveness, availability, and expected vaccination rates. Once similar levels of preventive efficacy have been established, it becomes increasingly important to determine which method best fits a country’s healthcare environment and financial circumstances.

Expanding access to preventive measures ultimately requires an assessment of the benefits relative to financial investment. According to a study conducted last year by Professor Seo Hye-Seon’s team at Kyung Hee University College of Pharmacy, administering nirsevimab to all infants under one year of age as well as high-risk children under two years was compared to the conventional strategy focusing only on high-risk groups. The results showed a reduction in medical costs related to hospitalization and emergency room visits, as well as decreased productivity loss for caregivers. More than 90% of the total health improvement was observed in full-term infants under one year old.

Similar analyses have been reported in other countries. In Italy, many regions found that the savings in hospital costs resulting from reduced RSV hospitalizations exceeded the cost of administering the prophylactic antibodies. In Japan, research indicated that expanding the target group for prevention to include all infants could further reduce disease burden and healthcare expenditures. According to estimates, for every 10 percentage point increase in the use of nirsevimab, approximately 2,780 additional lower respiratory tract RSV cases could be prevented.

In Korea, the RSV prophylactic antibody for healthy infants is not yet covered by insurance. The National Immunization Program (NIP) is currently vaccine-focused, and separate considerations are needed regarding how to support monoclonal antibody administration. The Korea Disease Control and Prevention Agency (KDCA) has stated that it is necessary to make a decision on government support only after comprehensively reviewing the disease burden of RSV and the anticipated scale of government expenditure.

This content was produced with the assistance of AI translation services.