Public health impact and cost-effectiveness of the adjuvanted RSVPreF3 vaccine for respiratory syncytial virus prevention among adults aged 50 years and older in Germany.

Background: Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract disease in older adults. Vaccination is effective against RSV disease and can reduce disease and economic burden.

Research design and methods: A static, multicohort Markov model was adapted to the German setting to estimate the public health impact and cost-effectiveness of adjuvanted RSVPreF3 vaccination strategies from a societal perspective in three target populations: 1) at increased risk (AIR) adults aged 50-59 years and all adults ≥60 years, 2) all adults aged ≥60 years, and 3) AIR adults aged 60-74 years and all adults ≥75 years. A cycle length of 1 month and a 5-year time horizon were adopted. Vaccine coverage was 75% in the base case.

Results: RSV vaccination is cost-effective versus no vaccination (<€50,000 willingness-to-pay threshold): incremental cost-effectiveness ratios were €19,789, €19,631, and €12,733 for strategies 1, 2, and 3, respectively; 1.6, 1.4, and 0.8 million outpatient visits and 192,402, 185,238, and 152,781 hospitalizations could be prevented with strategies 1, 2, and 3, respectively.

Conclusions: Expanding RSV vaccination to a larger target population would prevent more RSV cases, though at a higher cost per case averted; all vaccination strategies would be deemed cost-effective in Germany.