Economic and Clinical Benefits of Bivalent Respiratory Syncytial Virus Prefusion F (RSVpreF) Maternal Vaccine for Prevention of RSV in Infants: A Cost-Effectiveness Analysis for Mexico.

Abstract

Background/objectives: Respiratory syncytial virus (RSV) is a leading cause of respiratory infections in children. A novel RSVpreF vaccine for use among pregnant women for the prevention of RSV in infants is expected to be licensed in Mexico. Hence, the clinical and economic burden of RSV among infants in Mexico, with and without a year-round RSVpreF maternal vaccination program, was estimated.

Methods: A cohort model was developed to project clinical and economic outcomes of RSV from birth to 1 year of age for maternal vaccination and no intervention. Incremental cost-effectiveness ratios were calculated from direct cost outcomes, life years, and quality-adjusted life years (QALYs). The value per dose of the RSVpreF for which the program would be cost-effective was explored. Analyses were conducted from the healthcare system perspective, with direct costs (2024 Mexican Pesos [MXN]) and outcomes discounted at 5% annually; scenario and sensitivity analyses tested the robustness of model settings and inputs.

Results: Compared to no intervention, a year-round RSVpreF vaccine administered to 1891 M pregnant women would prevent 15,768 hospitalizations, 5505 emergency department cases, and 5505 physician office visits annually, averting MXN 1754 M in direct medical costs with an increase of 3402 life years or 3666 QALYs. The RSVpreF vaccine would be cost-saving up to MXN 1301/dose and cost-effective up to MXN 2105-MXN 3715/dose under an assumed cost-effectiveness threshold range of 1-3× the gross domestic product (GDP) per capita (MXN 247,310) per QALY gained.

Conclusions: Year-round RSVpreF maternal vaccination would substantially reduce RSV's clinical and economic burden among infants in Mexico and likely be a cost-effective program.