Wang Yingcheng, Fekadu Ginenus, You Joyce H S
School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
Vaccines (Basel). 2023 Oct 17;11(10):1605. doi: 10.3390/vaccines11101605.
Two respiratory syncytial virus (RSV) vaccines (AREXVY and ABRYSVO) were recently approved for older adults in the US. This study aimed to evaluate the cost-effectiveness of AREXVY and ABRYSVO from the Hong Kong public healthcare provider's perspective. A two-year decision-analytical model was developed to examine the outcomes of a single RSV vaccination (AREXVY or ABRYSVO) compared to no vaccination. Primary outcomes included RSV-related health outcomes, direct medical costs, quality-adjusted life-year (QALY) loss, and incremental cost per QALY (ICER). RSV vaccines are not yet marketed in Hong Kong, base-case analysis, therefore, benchmarked US RSV vaccine prices at 4 levels (25%, 50%, 75%, 100%). AREXVY and ABRYSVO (versus no vaccination) gained 0.000568 QALY and 0.000647 QALY, respectively. ICERs of ABRYSVO (26,209 USD/QALY) and AREXVY (47,485 USD/QALY) were lower than the willingness-to-pay threshold (49,594 USD/QALY) at 25% US vaccine price. The RSV attack rate was a common influential factor at all vaccine price levels. The probabilities of AREXVY and ABRYSVO to be most cost-effective were 0.10% and 97.68%, respectively, at 25% US vaccine price. Single vaccination of ABRYSVO or AREXVY for older adults appears to gain QALYs over 2 years in Hong Kong. The cost-effectiveness of AREXVY and ABRYSVO is subject to vaccine price and RSV attack rate.
两种呼吸道合胞病毒（RSV）疫苗（AREXVY和ABRYSVO）最近在美国被批准用于老年人。本研究旨在从香港公共医疗服务提供者的角度评估AREXVY和ABRYSVO的成本效益。开发了一个为期两年的决策分析模型，以检验单次RSV疫苗接种（AREXVY或ABRYSVO）与未接种疫苗相比的结果。主要结果包括与RSV相关的健康结果、直接医疗成本、质量调整生命年（QALY）损失以及每QALY的增量成本（ICER）。RSV疫苗尚未在香港上市，因此，基础案例分析将美国RSV疫苗价格设定在4个水平（25%、50%、75%、100%）。与未接种疫苗相比，AREXVY和ABRYSVO分别获得了0.000568个QALY和0.000647个QALY。在25%的美国疫苗价格下，ABRYSVO（26,209美元/QALY）和AREXVY（47,485美元/QALY）的ICER低于支付意愿阈值（49,594美元/QALY）。在所有疫苗价格水平下，RSV攻击率都是一个常见的影响因素。在25%的美国疫苗价格下，AREXVY和ABRYSVO最具成本效益的概率分别为0.10%和97.68%。在香港，对老年人单次接种ABRYSVO或AREXVY似乎在两年内可获得QALY。AREXVY和ABRYSVO的成本效益取决于疫苗价格和RSV攻击率。
