David Singer, Elizabeth M La, Jonathan Graham, Daniel Molnar, Mei Grace, Sara Poston, Frederik Verelst
{"title":"在美国50-59岁严重RSV疾病风险增加的成年人中，佐剂RSVPreF3疫苗的公共卫生影响和成本效益","authors":"David Singer, Elizabeth M La, Jonathan Graham, Daniel Molnar, Mei Grace, Sara Poston, Frederik Verelst","doi":"10.1007/s40121-025-01238-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Adults with certain comorbidities, including metabolic and cardiopulmonary diseases, are at increased risk of severe respiratory syncytial virus (RSV) disease. We evaluated the cost-effectiveness of adjuvanted RSVPreF3 vaccination in adults in the USA aged 50-59 years at increased risk of severe RSV.</p><p><strong>Methods: </strong>A Markov model with a 5-year time horizon estimated health and cost outcomes associated with adjuvanted RSVPreF3 vaccination in 3,259,715 adults aged 50-59 years with chronic obstructive pulmonary disease (COPD) from a societal perspective, compared with no vaccination. Inputs related to epidemiology, vaccine efficacy, and demographics came from published literature and public sources; assumptions, when needed, relied on expert consultation. A 46.2% vaccine uptake was assumed, on the basis of influenza vaccination. We reported incremental public health impact, costs, quality-adjusted life years (QALYs) lost, and incremental cost-effectiveness ratios. Scenario analyses investigated outcomes in adults aged 50-59 years with heart failure (HF), coronary artery disease (CAD), diabetes, or asthma.</p><p><strong>Results: </strong>Over a 5-year time horizon, one-time adjuvanted RSVPreF3 vaccination of 1,505,989 adults aged 50-59 years with COPD was projected to prevent 163,181 RSV acute respiratory illness cases, 126,565 lower respiratory tract disease cases, 11,609 RSV-related hospitalizations, 4117 emergency department visits, 816 deaths, and 12,144 QALY losses, compared with no vaccination. Adjuvanted RSVPreF3 vaccination was a cost-saving strategy (i.e., dominant) versus no vaccination in US adults aged 50-59 years with the modeled comorbidities, reducing societal costs and improving health outcomes in each scenario.</p><p><strong>Conclusions: </strong>In US adults aged 50-59 years at increased risk of severe RSV, a single dose of adjuvanted RSVPreF3 vaccination was projected to improve public health outcomes at a lower societal cost compared with no vaccination. Efforts are needed to ensure access to vaccination for populations at increased risk of severe RSV disease.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":""},"PeriodicalIF":5.3000,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Public Health Impact and Cost-Effectiveness of Adjuvanted RSVPreF3 Vaccination among Adults in the USA Aged 50-59 Years at Increased Risk of Severe RSV Disease.\",\"authors\":\"David Singer, Elizabeth M La, Jonathan Graham, Daniel Molnar, Mei Grace, Sara Poston, Frederik Verelst\",\"doi\":\"10.1007/s40121-025-01238-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Adults with certain comorbidities, including metabolic and cardiopulmonary diseases, are at increased risk of severe respiratory syncytial virus (RSV) disease. We evaluated the cost-effectiveness of adjuvanted RSVPreF3 vaccination in adults in the USA aged 50-59 years at increased risk of severe RSV.</p><p><strong>Methods: </strong>A Markov model with a 5-year time horizon estimated health and cost outcomes associated with adjuvanted RSVPreF3 vaccination in 3,259,715 adults aged 50-59 years with chronic obstructive pulmonary disease (COPD) from a societal perspective, compared with no vaccination. Inputs related to epidemiology, vaccine efficacy, and demographics came from published literature and public sources; assumptions, when needed, relied on expert consultation. A 46.2% vaccine uptake was assumed, on the basis of influenza vaccination. We reported incremental public health impact, costs, quality-adjusted life years (QALYs) lost, and incremental cost-effectiveness ratios. Scenario analyses investigated outcomes in adults aged 50-59 years with heart failure (HF), coronary artery disease (CAD), diabetes, or asthma.</p><p><strong>Results: </strong>Over a 5-year time horizon, one-time adjuvanted RSVPreF3 vaccination of 1,505,989 adults aged 50-59 years with COPD was projected to prevent 163,181 RSV acute respiratory illness cases, 126,565 lower respiratory tract disease cases, 11,609 RSV-related hospitalizations, 4117 emergency department visits, 816 deaths, and 12,144 QALY losses, compared with no vaccination. Adjuvanted RSVPreF3 vaccination was a cost-saving strategy (i.e., dominant) versus no vaccination in US adults aged 50-59 years with the modeled comorbidities, reducing societal costs and improving health outcomes in each scenario.</p><p><strong>Conclusions: </strong>In US adults aged 50-59 years at increased risk of severe RSV, a single dose of adjuvanted RSVPreF3 vaccination was projected to improve public health outcomes at a lower societal cost compared with no vaccination. Efforts are needed to ensure access to vaccination for populations at increased risk of severe RSV disease.</p>\",\"PeriodicalId\":13592,\"journal\":{\"name\":\"Infectious Diseases and Therapy\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":5.3000,\"publicationDate\":\"2025-10-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Infectious Diseases and Therapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s40121-025-01238-8\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infectious Diseases and Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s40121-025-01238-8","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Public Health Impact and Cost-Effectiveness of Adjuvanted RSVPreF3 Vaccination among Adults in the USA Aged 50-59 Years at Increased Risk of Severe RSV Disease.
Introduction: Adults with certain comorbidities, including metabolic and cardiopulmonary diseases, are at increased risk of severe respiratory syncytial virus (RSV) disease. We evaluated the cost-effectiveness of adjuvanted RSVPreF3 vaccination in adults in the USA aged 50-59 years at increased risk of severe RSV.
Methods: A Markov model with a 5-year time horizon estimated health and cost outcomes associated with adjuvanted RSVPreF3 vaccination in 3,259,715 adults aged 50-59 years with chronic obstructive pulmonary disease (COPD) from a societal perspective, compared with no vaccination. Inputs related to epidemiology, vaccine efficacy, and demographics came from published literature and public sources; assumptions, when needed, relied on expert consultation. A 46.2% vaccine uptake was assumed, on the basis of influenza vaccination. We reported incremental public health impact, costs, quality-adjusted life years (QALYs) lost, and incremental cost-effectiveness ratios. Scenario analyses investigated outcomes in adults aged 50-59 years with heart failure (HF), coronary artery disease (CAD), diabetes, or asthma.
Results: Over a 5-year time horizon, one-time adjuvanted RSVPreF3 vaccination of 1,505,989 adults aged 50-59 years with COPD was projected to prevent 163,181 RSV acute respiratory illness cases, 126,565 lower respiratory tract disease cases, 11,609 RSV-related hospitalizations, 4117 emergency department visits, 816 deaths, and 12,144 QALY losses, compared with no vaccination. Adjuvanted RSVPreF3 vaccination was a cost-saving strategy (i.e., dominant) versus no vaccination in US adults aged 50-59 years with the modeled comorbidities, reducing societal costs and improving health outcomes in each scenario.
Conclusions: In US adults aged 50-59 years at increased risk of severe RSV, a single dose of adjuvanted RSVPreF3 vaccination was projected to improve public health outcomes at a lower societal cost compared with no vaccination. Efforts are needed to ensure access to vaccination for populations at increased risk of severe RSV disease.
期刊介绍：
Infectious Diseases and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of infectious disease therapies and interventions, including vaccines and devices. Studies relating to diagnostic products and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged.
Areas of focus include, but are not limited to, bacterial and fungal infections, viral infections (including HIV/AIDS and hepatitis), parasitological diseases, tuberculosis and other mycobacterial diseases, vaccinations and other interventions, and drug-resistance, chronic infections, epidemiology and tropical, emergent, pediatric, dermal and sexually-transmitted diseases.
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