Department of Health Sciences, University of Groningen, University Medical Centre, Groningen, the Netherlands.
Department of Medical Microbiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
J Infect Dis. 2022 Aug 12;226(Suppl 1):S102-S109. doi: 10.1093/infdis/jiab118.
In older adults, the burden of respiratory syncytial virus (RSV) resembles that of influenza and may even be considered worse due to the lack of preventive interventions. This study was performed to identify the available literature on RSV infection in older adults, and to provide updated exploratory results of the cost-effectiveness of a hypothetical RSV vaccine in the Netherlands and the United Kingdom.
A literature search was performed in Medline and EMBASE on 11 November 2019, which served as input for a static decision-tree model that was used to estimate the EJP, for an RSV vaccine applying different willingness-to-pay (WTP) thresholds. WTP thresholds applied were €20 000 and €50 000 per quality-adjusted life-year for the Netherlands, and £20 000 and £30 000 per quality-adjusted life-year for the United Kingdom. Analyses were-in line with country-specific guidelines-conducted from a societal perspective for the Netherlands and a third-party payer perspective for the United Kingdom. The robustness of the cost-effectiveness results was tested in sensitivity analysis.
After screening the literature, 3 studies for the Netherlands and 6 for the United Kingdom remained to populate the country-specific models. In the base case analysis for the Netherlands (mean RSV incidence, 3.32%), justifiable vaccine prices of €16.38 and €50.03 were found, based on applying the lower and higher WTP thresholds, respectively. Similarly, for the United Kingdom (mean incidence, 7.13%), vaccine prices of £72.29 and £109.74 were found, respectively.
RSV vaccination may well be cost-effective in both the Netherlands and the United Kingdom, depending on the exact RSV incidence, vaccine effectiveness and price. However, sensitivity analysis showed that the results were robust based on varying the different parameter estimates and assumptions. With RSV vaccines reaching the final stages of development, a strong need exists for cost-effectiveness studies to understand economically justifiable pricing of the vaccine.
在老年人中，呼吸道合胞病毒（RSV）的负担与流感相似，由于缺乏预防干预措施，甚至可能被认为更糟。本研究旨在确定关于老年人 RSV 感染的现有文献，并提供荷兰和英国假设 RSV 疫苗成本效益的最新探索性结果。
2019 年 11 月 11 日，在 Medline 和 EMBASE 上进行了文献检索，作为输入，为静态决策树模型提供了信息，该模型用于估计 EJP，用于应用不同意愿支付（WTP）阈值的 RSV 疫苗。应用的 WTP 阈值为荷兰每质量调整生命年 20000 欧元和 50000 欧元，英国每质量调整生命年 20000 英镑和 30000 英镑。分析是按照国家特定的指南进行的，对于荷兰，从社会角度进行分析，对于英国，从第三方支付者的角度进行分析。在敏感性分析中测试了成本效益结果的稳健性。
在筛选文献后，为荷兰的 3 项研究和英国的 6 项研究留下了研究，以填充特定国家的模型。在荷兰（平均 RSV 发病率为 3.32%）的基本案例分析中，根据应用较低和较高的 WTP 阈值，发现了合理的疫苗价格分别为 16.38 欧元和 50.03 欧元。同样，在英国（平均发病率为 7.13%），分别发现了疫苗价格为 72.29 英镑和 109.74 英镑。
根据 RSV 的确切发病率、疫苗效力和价格，RSV 疫苗在荷兰和英国很可能具有成本效益。然而，敏感性分析表明，基于不同参数估计和假设的变化，结果是稳健的。随着 RSV 疫苗进入最后开发阶段，强烈需要进行成本效益研究，以了解疫苗具有经济合理性的定价。
