Cost-effectiveness of bivalent respiratory syncytial virus Prefusion F (RSVpreF) maternal vaccine among infants in the United States

IF 4.5 3区医学 Q2 IMMUNOLOGY

Vaccine Pub Date : 2025-05-17 DOI:10.1016/j.vaccine.2025.127191

Ahuva Averin , Erin Quinn , Mark Atwood , Derek Weycker , Kimberly M. Shea , Amy W. Law

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引用次数: 0

Abstract

Background

Respiratory syncytial virus (RSV) is a leading cause of respiratory tract illness (RTI) among young children. The novel bivalent stabilized prefusion F subunit vaccine (RSVpreF) for pregnant people to protect their infants against RSV lower respiratory tract illness (RSV-LRTI) was recommended by the US Advisory Committee on Immunization Practices for use among pregnant persons between 32 and 36 weeks of gestation in September 2023. We evaluated the cost-effectiveness of maternal RSVpreF for prevention of RSV among US infants.

Methods

A cohort model was employed to depict clinical outcomes and economic costs of RSV from birth to age 1 year and lifetime consequences of premature RSV-related death. Cost-effectiveness of year-round and, alternatively, seasonally administered RSVpreF was evaluated compared to no intervention. Model inputs include RSV disease and case-fatality rates; vaccine effectiveness (derived from trial analyses); and costs of RSVpreF, RSV treatment, and caregiver work loss. Clinical outcomes (projected monthly) included cases of medically attended RSV, RSV-LRTI deaths, and quality-adjusted LYs (QALYs). Economic costs were generated based on vaccines administered as well as cases and corresponding unit costs and were reported in 2023 US$. Costs and benefits were discounted 3 % annually.

Results

Year-round maternal vaccination with RSVpreF resulted in a reduction of 13,349 hospitalizations, 32,414 emergency department encounters, and 96,540 outpatient clinic visits, corresponding with an increase in direct medical costs of $366 million and decrease in indirect (non-medical) costs of $80 million. With 2264 additional QALYs, the cost-effectiveness ratio was $89,733/QALY. Seasonal maternal vaccination prevented 23–39 % fewer cases (care setting dependent), but was cost saving overall, resulting in a dominant cost-effectiveness ratio.

Conclusion

Maternal vaccination with RSVpreF would substantially reduce the clinical and economic burden of RSV in infants, resulting in a cost-effectiveness ratio of $89,733 per QALY if administered year-round or cost savings if administered seasonally.

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二价呼吸道合胞病毒预融合F （RSVpreF）疫苗在美国婴儿中的成本效益

呼吸道合胞病毒（RSV）是幼儿呼吸道疾病（RTI）的主要病因。美国免疫实践咨询委员会推荐于2023年9月在妊娠32至36周的孕妇中使用新型二价稳定预融合F亚单位疫苗（RSVpreF），以保护其婴儿免受RSV下呼吸道疾病（RSV- lrti）的侵害。我们评估了母亲RSVpreF预防美国婴儿RSV的成本效益。方法采用队列模型描述RSV从出生到1岁的临床结局和经济成本以及RSV相关过早死亡的终生后果。与不干预相比，评估了全年或季节性给予RSVpreF的成本效益。模型输入包括RSV疾病和病死率；疫苗有效性（来自试验分析）；以及RSV pref、RSV治疗和护理人员工作损失的费用。临床结果（每月预测）包括医学治疗的RSV病例、RSV- lrti死亡病例和质量调整LYs （QALYs）。经济成本是根据接种的疫苗以及病例和相应的单位成本产生的，并以2023年美元报告。成本和收益每年折现3%。结果孕产妇全年接种RSVpreF疫苗后，住院人数减少13349人，急诊人数减少32414人，门诊人数减少96540人，直接医疗费用增加3.66亿美元，间接（非医疗）费用减少8000万美元。加上2264个额外的质量年，成本效益比为89,733美元/质量年。季节性母亲疫苗接种预防的病例减少23 - 39%（取决于护理环境），但总体上节省了成本，导致成本效益比占主导地位。结论母亲接种RSV疫苗可显著减轻婴儿RSV的临床和经济负担，如果全年接种，每个QALY的成本-效果比为89,733美元，如果季节性接种则可节省成本。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vaccine 医学-免疫学

CiteScore

8.70

自引率

5.50%

发文量

992

审稿时长

131 days

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