La Elizabeth M, Graham Jonathan, Singer David, Molnar Daniel, Poston Sara, Curran Desmond, Pickett Jessica, Verelst Frederik
US Health Economics and Outcomes Research, Vaccines, GSK, Philadelphia, PA, USA.
Health Economics, RTI Health Solutions, Research Triangle Park, NC, USA.
Hum Vaccin Immunother. 2024 Dec 31;20(1):2432745. doi: 10.1080/21645515.2024.2432745. Epub 2024 Dec 9.
Respiratory syncytial virus (RSV) is a common cause of acute respiratory illness in individuals of all ages, with adults aged ≥60 years and adults with certain chronic conditions at increased risk of severe RSV-related outcomes. This study evaluates the cost-effectiveness of the adjuvanted RSVPreF3 vaccine versus no vaccine in adults aged ≥60 years in the United States (US). A multi-cohort Markov model was developed with a 5-year time horizon and 1-month cycle length to compare outcomes for no vaccination and one-time adjuvanted RSVPreF3 vaccination (assuming the same vaccination as for influenza vaccines). Clinical parameters (e.g., vaccine efficacy) were based on phase 3 clinical trial data over 3 seasons, with all other inputs obtained from public US sources and scientific literature. Outcomes included total and incremental quality-adjusted life year (QALY) losses and costs, as well as incremental cost-effectiveness ratios (ICERs). Sensitivity analyses were conducted to evaluate the sensitivity of results to inputs. In the base case, the model estimated that vaccinating 52.7 million adults aged ≥60 years with the adjuvanted RSVPreF3 vaccine once would result in 244,424 fewer QALY losses and an incremental societal cost of $4.5 billion over 5 years, with vaccination costs partially offset by reduced disease-related costs. From the societal perspective, adjuvanted RSVPreF3 vaccination resulted in an ICER of $18,430 per QALY gained. Results were relatively robust across sensitivity analyses and indicate that adjuvanted RSVPreF3 vaccination is a cost-effective option for the prevention of RSV in US adults aged ≥ 60 years, reducing the substantial burden within this population.
呼吸道合胞病毒（RSV）是各年龄段人群急性呼吸道疾病的常见病因，60岁及以上的成年人以及患有某些慢性病的成年人发生严重RSV相关后果的风险更高。本研究评估了佐剂RSVPreF3疫苗与不接种疫苗相比，在美国60岁及以上成年人中的成本效益。开发了一个多队列马尔可夫模型，时间范围为5年，周期长度为1个月，以比较不接种疫苗和一次性接种佐剂RSVPreF3疫苗（假设与流感疫苗接种方式相同）的结果。临床参数（如疫苗效力）基于3个季节的3期临床试验数据，所有其他输入数据均来自美国公共来源和科学文献。结果包括总的和增量的质量调整生命年（QALY）损失和成本，以及增量成本效益比（ICER）。进行敏感性分析以评估结果对输入数据的敏感性。在基础案例中，该模型估计，对5270万60岁及以上的成年人一次性接种佐剂RSVPreF3疫苗，在5年内将减少244,424个QALY损失，增加社会成本45亿美元，疫苗接种成本部分被疾病相关成本的降低所抵消。从社会角度来看，接种佐剂RSVPreF3疫苗导致每获得一个QALY的ICER为18,430美元。敏感性分析的结果相对稳健，表明接种佐剂RSVPreF3疫苗是预防美国60岁及以上成年人RSV的一种具有成本效益的选择，可减轻该人群的沉重负担。
