Italy is set to undergo a significant shift in its approach to combating Respiratory Syncytial Virus (RSV) among infants. With the introduction of nirsevimab, a new prophylactic strategy, the country aims to extend protection beyond high-risk groups, potentially altering the landscape of RSV management and its associated economic burden.
Current RSV Burden and Prophylaxis Strategy in Italy
Under the existing standard of care (SoC), palivizumab is administered only to high-risk infants, representing a mere 4.4% of the estimated birth cohort. This selective approach has led to an estimated 216,100 RSV-MA-LRTIs, 15,121 associated complications, and 16 RSV-related deaths in a single RSV season. The economic implications are substantial, with losses totaling approximately €50.5 million in RSV-MA-LRTI management, €10.9 million due to complications, and €3 million in productivity losses from RSV-induced deaths.
Potential Impact of Nirsevimab on Health and Economy
The introduction of nirsevimab, targeting all infants regardless of risk status, is projected to prevent 100,208 RSV-MA-LRTIs, 6,969 complications, and 6 deaths during one RSV season. Economically, this translates to savings of approximately €23.3 million in RSV-MA-LRTI management, €5 million in complications, and €1.2 million from prevented deaths. This broader prophylactic approach promises not only enhanced health outcomes but also significant financial relief for the healthcare system and the economy at large.
Key inferences:
- Nirsevimab adoption could nearly halve the number of RSV-MA-LRTIs compared to the current SoC.
- Substantial economic savings highlight the cost-effectiveness of universal prophylaxis over restricted use.
- Reducing RSV-related complications and deaths enhances overall infant health and reduces long-term healthcare needs.
The transition to a nirsevimab-inclusive prophylaxis strategy represents a proactive step toward comprehensive infant health protection. By expanding the scope of preventive measures, Italy could witness a notable decline in RSV incidence and its cascading effects on health services and the economy. This strategy aligns with global health goals of reducing pediatric respiratory infections and could set a precedent for other nations grappling with similar challenges.
Moreover, the economic savings derived from reduced healthcare expenditures and increased productivity underscore the value of investing in widespread preventative treatments. As healthcare systems worldwide face budget constraints, demonstrating the cost-effectiveness of such interventions becomes pivotal. Nirsevimab’s potential to alleviate both clinical and financial burdens makes it a compelling option for inclusion in national health protocols.
Implementing nirsevimab universally could also foster greater public trust in preventative healthcare measures. By ensuring all infants receive protection against RSV, the healthcare system emphasizes equity and accessibility, potentially encouraging higher vaccine compliance rates and engagement with other essential health services.
In tandem with robust prophylaxis, ongoing monitoring and research will be vital to assess the long-term impacts of nirsevimab use. Data-driven approaches can inform future strategies, optimize resource allocation, and ensure that the benefits of such interventions are maximized across diverse populations.
As Italy progresses with this new prophylaxis strategy, the lessons learned could inform global practices in managing RSV and other similar infectious diseases. The potential reduction in clinical cases and economic strain provides a model for health policy evolution, emphasizing the importance of inclusive and comprehensive healthcare strategies in safeguarding public health.

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