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. 2022 Aug 15;226(Suppl 2):S293-S299.
doi: 10.1093/infdis/jiac164.

Inequalities in Health Impact of Alternative Reimbursement Pathways for Nirsevimab in the United States

Gabriela B Gomez  1   2 , Christopher B Nelson  3 , Christopher Rizzo  3 , Donald S Shepard  4 , Sandra S Chaves  1
Affiliations

Inequalities in Health Impact of Alternative Reimbursement Pathways for Nirsevimab in the United States

Gabriela B Gomez et al. J Infect Dis. .

Abstract

The target populations and financing mechanisms for a new health technology may affect health inequalities in access and impact. We projected the distributional consequences of introducing nirsevimab for prevention of respiratory syncytial virus in a US birth cohort of infants through alternative reimbursement pathway scenarios. Using the RSV immunization impact model, we estimated that a vaccine-like reimbursement pathway would cover 32% more infants than a pharmaceutical pathway. The vaccine pathway would avert 30% more hospitalizations and 39% more emergency room visits overall, and 44% and 44%, respectively, in publicly insured infants. The vaccine pathway would benefit infants from poorer households.

Keywords: United States; equity; health care utilization; infants; insurance; lower respiratory tract infections; model; respiratory syncytial virus infections.

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Conflict of interest statement

Potential conflicts of interest. G. B. G., C. R., C. B. N., and S. S. C. are employees of Sanofi, a company which makes Nirsevimab, a monoclonal antibody for RSV prevention, and may own Sanofi shares. Sanofi employees were involved in all aspects of data collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication. D. S. S. received grant funding from Sanofi. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

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