INTRODUCTION & OBJECTIVE: Older adults and adults with comorbidities, such as metabolic diseases, are at increased risk of severe respiratory syncytial virus (RSV) disease. This study assessed the cost-effectiveness of adjuvanted RSVPreF3 vaccination in adults 50-59 years of age (YOA) with diabetes in the US.
METHODS: A Markov model was used to estimate costs and health outcomes over a 3-year time horizon from a societal perspective, comparing scenarios with and without one-time adjuvanted RSVPreF3 vaccination. Indirect costs and quality-adjusted life year (QALY) losses due to RSV-related death were modeled over the remaining lifetime. The population included 5,617,227 US adults 50-59 YOA with diabetes. Vaccination coverage of 50.1% was assumed, based on influenza vaccination coverage. Scientific literature and public sources were used to inform model inputs. Incremental cost and health outcomes were reported along with the incremental cost-effectiveness ratio (ICER), comparing adjuvanted RSVPreF3 vaccination to no vaccination.
RESULTS: Over the 3-year time horizon, adjuvanted RSVPreF3 vaccination avoided an estimated 180,546 symptomatic RSV acute respiratory illnesses, including 144,676 lower respiratory tract disease cases, 108,392 RSV-related outpatient visits, and 7,841 RSV-related hospitalizations. Vaccination resulted in incremental total societal costs of -$39 million (M), including incremental direct and indirect costs of $623M and -$662M, respectively. Adjuvanted RSVPreF3 vaccination avoided 10,290 QALY losses and 551 RSV-related deaths. With improved health outcomes and lower societal costs, adjuvanted RSVPreF3 vaccination was dominant versus no vaccination (ICER <$0 per QALY gained).
CONCLUSION: One-time adjuvanted RSVPreF3 vaccination resulted in improved health outcomes and reduced societal costs compared to no vaccination, suggesting it is cost-effective for the prevention of RSV in adults 50-59 YOA with diabetes.
