OBJECTIVES: Older adults and adults with chronic cardiopulmonary diseases are at increased risk of severe respiratory syncytial virus (RSV) disease. This study examined the cost-effectiveness of adjuvanted RSVPreF3 vaccination in adults 50-59 years of age (YOA) with select cardiopulmonary diseases.
METHODS: A Markov model using a 3-year time horizon estimated outcomes from a societal perspective with and without one dose of the adjuvanted RSVPreF3 vaccine among adults 50-59 YOA with chronic obstructive pulmonary disease (COPD; n=3,299,241), heart failure (HF; n=712,959), coronary artery disease (CAD; n=2,865,359), and asthma (n=3,439,066). Quality-adjusted life year (QALY) losses and indirect costs due to RSV-related mortality were assessed over the remaining lifetime. Model inputs were informed by scientific literature and public sources . The model assumed 50.1% vaccination coverage (equal to influenza vaccination coverage in this age group). Incremental costs, QALYs, and incremental cost-effectiveness ratios (ICER) were reported. One-way and probabilistic sensitivity analyses were conducted to assess the sensitivity of results to uncertainty in model inputs.
RESULTS: Incremental societal costs with adjuvanted RSVPreF3 vaccination versus no vaccination were -$422 million (M), -$255M, -$182M, and $50M for adults 50-59 YOA with COPD, HF, CAD, and asthma, respectively, accounting for RSV vaccination costs and cost offsets from avoided RSV cases over 3 years . Adjuvanted RSVPreF3 vaccination was projected to avoid discounted QALY losses of 8,860, 3,081, 6,230, and 5,887 for COPD, HF, CAD, and asthma populations, respectively. Compared to no vaccination, adjuvanted RSVPreF3 vaccination was dominant, reducing societal costs and improving health outcomes for adults 50-59 YOA with COPD, HF, and CAD; for adults 50-59 YOA with asthma, the ICER was $8,577 per QALY gained. Results were generally robust to input uncertainty.
CONCLUSIONS: Adjuvanted RSVPreF3 vaccination is cost-effective for the prevention of RSV in adults 50-59 YOA with the modeled cardiopulmonary diseases, representing an efficient use of healthcare resources.
