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. 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. 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. 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. 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. Health and cost outcomes associated with adjuvanted RSVPreF3 vaccination were modeled over a 5-year time horizon for about 3.3 million adults aged 50–59 years with chronic obstructive pulmonary disease from a societal perspective, compared with no vaccination. Inputs came from published literature and public sources; assumptions, when needed, relied on expert consultation. Scenario analyses investigated outcomes in adults aged 50–59 years with heart failure, coronary artery disease, diabetes, or asthma. Over a 5-year time horizon, one-time adjuvanted RSVPreF3 vaccination of about 1.5 million adults aged 50–59 years with chronic obstructive pulmonary disease was projected to prevent > 160,000 RSV acute respiratory illness cases, > 126,000 lower respiratory tract disease cases, > 11,600 RSV-related hospitalizations, > 4000 emergency department visits, and 816 deaths, compared with no vaccination. Adjuvanted RSVPreF3 vaccination reduced costs and improved health outcomes compared with no vaccination in US adults aged 50–59 years with the modeled comorbidities. Efforts are needed to ensure access to vaccination for populations at increased risk of severe RSV disease.
Singer et al. (Sat,) studied this question.