OBJECTIVES: Risk of severe respiratory syncytialvirus (RSV) disease is increased among adults with cardiopulmonary disease. This study modeled the public health impact and cost-effectiveness of adjuvanted RSVPreF3 vaccination in US adults ≥60 years of age (YOA) with specific prevalent cardiopulmonary diseases.
METHODS: RSV-related health and cost outcomes withand without one-time adjuvanted RSVPreF3 vaccination were estimated using astatic multi-cohort Markov model. Analyses included adults ≥60 YOA with chronic obstructive pulmonary disease (COPD; n=9,728,877), asthma (n=6,710,866), heart failure (HF; n=5,318,193), or coronary artery disease (CAD; n=15,154,814). Themodel used a 5-year time horizon and assumed the same uptake as for influenza vaccines (60-64 YOA: 46.2%; ≥65 YOA: 69.7%). Other inputs were obtained from literature, public sources, and clinical trial results. Key incremental outcomes (e.g., RSV lower respiratory tract disease [LRTD] cases) and incremental cost-effectiveness ratios were calculated.
RESULTS: Among adults ≥60 YOA with cardiopulmonary disease, adjuvanted RSVPreF3 vaccination was associated with fewer RSV-LRTD cases, healthcare resource use, and deaths. The largest impact was projected for CAD, where vaccinating approximately 9.7 million adults ≥60 YOA with CAD resulted in 754,446 fewer RSV-LRTD cases over 5 years, avoiding 157,906 RSV-related hospitalizations and 16,395 RSV-related deaths. For the other modeled populations, avoided RSV-LRTD cases ranged from 262,883 (HF) to 497,216 (COPD), avoided RSV-related hospitalizations ranged from 39,512 (asthma) to 157,676 (COPD), and avoided RSV-related deaths ranged from 4,024 (asthma) to 16,202 (COPD) over 5 years. Across all modeled populations, adjuvanted RSVPreF3 vaccination was dominant versus no vaccination, resulting in societal cost savings (range: $1.6 billion [asthma] to $8.1 billion [COPD]) and fewer quality-adjusted life year losses.
CONCLUSIONS: Adjuvanted RSVPreF3 vaccination among adults ≥60 YOA with cardiopulmonary disease was projected to reduce both RSV disease burden and societal costs. However, achieving these outcomes in real-world practice would require efforts to improve RSV vaccination uptake.
