Gourzoulidis George, Tzanetakos Charalampos, Solakidi Argyro, Markatis Eleftherios, Detsis Marios, Mendes Diana, Barmpouni Myrto
Health Through Evidence, 174 56 Athens, Greece.
Pfizer Hellas, 154 51 Athens, Greece.
Vaccines (Basel). 2024 Oct 29;12(11):1232. doi: 10.3390/vaccines12111232.
BACKGROUND/OBJECTIVES: To evaluate the health benefits, costs, and cost-effectiveness of vaccination with bivalent respiratory syncytial virus stabilized prefusion F vaccine (RSVpreF) for the prevention of lower respiratory tract disease caused by respiratory syncytial virus (RSV) in Greek adults 60 years of age and older.
A Markov model was adapted to simulate lifetime risk of health and economic outcomes from the public payer's perspective over a lifetime horizon. Epidemiology, vaccine effectiveness, utilities, and direct medical costs (EUR, 2024) were obtained from published studies, official sources, and local experts. Model outcomes included the number of medically attended RSV cases, stratified by care setting (i.e., hospital, emergency department [ED], outpatient visits [OV]), and attributable RSV-related deaths, costs, life years (LY), quality-adjusted life-years (QALY), and incremental cost-effectiveness ratios (ICERs) of RSVpreF vaccination compared with no vaccination.
The model projected 258,170 hospitalizations, 112,248 ED encounters, 1,201,604 OV, and 25,463 deaths related to RSV in Greek older adults resulting in direct medical costs of EUR 1.6 billion over the lifetime horizon. Assuming RSV vaccination would reach the same coverage rates as pneumococcal and influenza programmes, 18,118 hospitalizations, 7874 ED encounters, 48,079 OV, and 1706 deaths could be prevented over the modelled time horizon. The health benefits associated with RSVpreF contributed to an incremental gain of 10,976 LYs and 7230 QALYs compared with no vaccination. The incremental analysis reported that vaccination with RSVpreF was estimated to be a cost-effective strategy resulting in ICERs of EUR 12,991 per LY gained, EUR 19,723 per QALY gained, and EUR 7870 per hospitalized RSV case avoided compared with no vaccination.
Vaccination with RSVpreF was a cost-effective strategy for the prevention of RSV disease in Greek adults over 60 years of age. The introduction of RSV vaccination can improve public health by averting RSV cases and deaths and has the potential to fulfil an unmet medical need.
背景/目的：评估使用二价呼吸道合胞病毒稳定前融合F疫苗（RSVpreF）预防希腊60岁及以上成年人由呼吸道合胞病毒（RSV）引起的下呼吸道疾病的健康效益、成本和成本效益。
采用马尔可夫模型，从公共支付者的角度模拟一生的健康和经济结果风险。流行病学、疫苗效力、效用和直接医疗成本（欧元，2024年）来自已发表的研究、官方来源和当地专家。模型结果包括按护理环境（即医院、急诊科[ED]、门诊就诊[OV]）分层的就医RSV病例数、RSV相关归因死亡数、成本、生命年（LY）、质量调整生命年（QALY）以及与未接种疫苗相比RSVpreF疫苗接种的增量成本效益比（ICER）。
该模型预测，希腊老年人中与RSV相关的住院病例有258,170例，急诊科就诊112,248次，门诊就诊1,201,604次，死亡25,463例，在整个生命周期内导致直接医疗成本16亿欧元。假设RSV疫苗接种覆盖率与肺炎球菌和流感疫苗接种项目相同，在模拟的时间范围内可预防18,118例住院病例、7874次急诊科就诊、48,079次门诊就诊和1706例死亡。与未接种疫苗相比，RSVpreF带来的健康效益使生命年增加了10,976个，质量调整生命年增加了7230个。增量分析表明，与未接种疫苗相比，RSVpreF疫苗接种估计是一种具有成本效益的策略，每获得1个生命年的增量成本效益比为12,991欧元，每获得1个质量调整生命年为19,723欧元，每避免1例RSV住院病例为7870欧元。
RSVpreF疫苗接种是预防希腊60岁以上成年人RSV疾病的一种具有成本效益的策略。引入RSV疫苗接种可通过避免RSV病例和死亡来改善公共卫生，并有可能满足未满足的医疗需求。
