BACKGROUND: In 2023, the adjuvanted RSVPreF3 vaccine was approved in the United States (US) for prevention of lower respiratory tract disease caused by respiratory syncytial virus (RSV) in adults aged ≥60 years. The current study evaluates the public health impact and cost-effectiveness of this vaccine versus no vaccine in US adults aged ≥60 years.
METHODS: A multi-cohort Markov model compared clinical and economic outcomes for scenarios with and without adjuvanted RSVPreF3 vaccination among US older adults (n=82,862,258). The model used a 3-year time horizon, with vaccine efficacy based on phase 3 clinical trial data through 2 full RSV seasons. The model assumed vaccination in October, using the same coverage as for influenza vaccines. Sensitivity analyses assessed the impact of parameter uncertainty on results.
RESULTS: Without vaccination, RSV resulted in an estimated 3.8 million (M) symptomatic cases annually among US older adults, including 1.8M outpatient visits, 178,421 hospitalizations, and 14,566 deaths. Vaccinating 56.7M older adults with the adjuvanted RSVPreF3 vaccine once at simulation start was estimated to avert 3.0M symptomatic RSV cases, 1.6M outpatient visits, 203,891 hospitalizations, and 16,660 deaths over 3 years (versus no vaccination). Vaccination further resulted in 172,442 fewer quality-adjusted life year (QALY) losses and an incremental societal cost of $8.9 billion, for an incremental cost-effectiveness ratio of $51,621 per QALY gained.
CONCLUSIONS: Results indicate that the adjuvanted RSVPreF3 vaccine is a cost-effective option for the prevention of RSV in US adults aged ≥60 years, with the potential to substantially reduce RSV burden.
