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. 2024 Jan-Dec;23(1):986-996.
doi: 10.1080/14760584.2024.2410898. Epub 2024 Oct 30.

Cost-effectiveness analysis of respiratory syncytial virus vaccination with the adjuvanted prefusion F protein vaccine (RSVPreF3 OA) for adults ≥60 years old in Japan

Akiko Mizukami  1 , Victor Preckler  2   3 , Frederik Verelst  2 , Taizo Matsuki  1   4 , Yufan Ho  5 , Daisuke Kurai  6 , Daniel Molnar  2
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Free article

Cost-effectiveness analysis of respiratory syncytial virus vaccination with the adjuvanted prefusion F protein vaccine (RSVPreF3 OA) for adults ≥60 years old in Japan

Akiko Mizukami et al. Expert Rev Vaccines. 2024 Jan-Dec.
Free article

Abstract

Objectives: Older adults (OA) are at risk of morbidity and mortality from respiratory syncytial virus (RSV), a major cause of seasonal acute respiratory illness. The first RSV vaccine for OA (RSVPreF3 OA) was recently launched in Japan. With the already large and growing OA population in Japan, and limited RSV treatments, prevention is key. The aim of this study was to assess the cost-effectiveness of introducing RSVPreF3 OA for Japanese adults aged ≥60 years.

Methods: A static multicohort Markov model was adapted to assess the cost-effectiveness of a single dose of RSVPreF3 OA versus no vaccination over a three-year time horizon. Deterministic and probabilistic sensitivity analyses were conducted to assess parameter uncertainty.

Results: RSVPreF3 OA vaccination prevented 1,008,499 cases and 6,840 deaths, with 109,119 quality-adjusted life-years (QALYs) gained. The incremental cost-effectiveness ratio was Japanese yen (JPY) 4,180,084/QALY gained from a payer perspective and JPY 4,041,917/QALY gained from a societal perspective (with productivity loss from RSV disease), thus vaccination was considered cost-effective. Base case results were robust to changes in sensitivity and scenario analyses.

Conclusions: RSVPreF3 OA vaccination for adults ≥60 years can provide substantial health benefits and is a cost-effective intervention to reduce the RSV burden in Japan.

Keywords: Adults; Japan; cost-effectiveness; prefusion F protein vaccine; respiratory syncytial virus.

Plain language summary

What is the context?Respiratory syncytial virus (RSV) is a major cause of acute respiratory illness which can be severe, leading to hospitalization, and in some cases, to death, especially in older adults (OA). Nearly a third of the Japanese population are OA. There are limited treatment options for RSV. Vaccination is a novel and efficacious intervention to prevent RSV illness. The first vaccine against RSV in OA (RSVPreF3 OA) has been launched in Japan, and evidence on its cost-effectiveness is needed to inform health policy decisions and efficient resource allocation.What is new?A model was used to estimate the public health impact of RSV vaccination in OA aged ≥60 years in Japan on the numbers of RSV cases and deaths compared with the current situation of no RSV vaccination. The cost-effectiveness of RSV vaccination was also calculated. The model primarily used Japanese data from published literature and government statistics, and in addition, from the phase III clinical trial of RSVPreF3 OA, to provide robust estimates.What is the impact?The model estimated that a single dose of vaccination (with a 50% vaccination coverage rate) would prevent around 1 million cases of RSV in OA, and nearly 7,000 deaths over three years. Considering the cost of vaccination and the cost savings from RSV prevention, vaccination was found to be cost-effective (the incremental cost per quality-adjusted life-year gained was JPY 4,180,084, which is below the commonly cited threshold for cost-effectiveness). RSV vaccination could reduce the burden of RSV in the Japanese OA population.

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