Impact and cost-effectiveness of two interventions to prevent paediatric respiratory syncytial virus disease in Cameroon: a modelling approach

This peer-reviewed modelling study assesses the potential impact and cost-effectiveness of two respiratory syncytial virus (RSV) prevention strategies for children under five years old in Cameroon: a long-acting infant monoclonal antibody (nirsevimab) and a maternal RSV vaccine (bivalent RSVpreF). Using the UNIVAC static proportionate outcomes model and drawing on evidence from published literature, Demographic and Health Surveys, WHO/UNICEF data, clinical trials, and consultations with national stakeholders, the analysis estimates the health and economic outcomes of introducing these interventions between 2025 and 2034. 

Key findings

• Without intervention, RSV was estimated to cause more than 8,200 deaths and over 204,000 DALYs among children under five years old in Cameroon between 2025 and 2034.
• Both the infant monoclonal antibody and maternal RSV vaccine could reduce RSV mortality among children under five years old by around 27%, preventing more than 2,200 deaths each over 10 years.
• Both interventions were estimated to avert more than 55,000 DALYs over the study period.
• The incremental cost-effectiveness ratio for both interventions was estimated at approximately USD 500 per DALY averted at an assumed price of USD 5 per dose.
• Probabilistic sensitivity analyses suggested that both interventions had more than a 90% probability of being cost-effective at a threshold equivalent to 0.5 times Cameroon’s GDP per capita when priced at USD 5 per dose.
• The study estimated that both interventions would likely need to be priced below approximately USD 2.50 per dose to be considered cost-effective at a more conservative threshold of 0.1 times GDP per capita.

Thumbnail image credit: Gavi