Cost-Effectiveness of an RSVpreF Vaccine for Prevention of Respiratory Syncytial Virus Outcomes in Infants

Key Messages

• From CADTH’s search of the economic literature, 4 economic studies were identified that assessed the cost-effectiveness of respiratory syncytial virus (RSV) immunization during pregnancy in high-income countries, including 1 study set in Nunavik, Quebec. Only 1 of these studies specifically considered the product of interest (RSVpreF), and only in a scenario analysis.
• In the 4 identified studies that evaluated the cost-effectiveness of RSV immunization during pregnancy, the outcomes predicted by the models focused on those related to infants. There is a lack of evidence on outcomes — thus cost-effectiveness — for the persons who are pregnant.
• The results from the 4 studies varied considerably. RSV immunization during pregnancy ranged from being more effective and associated with lower total costs (dominant) to more than $200,000 per quality-adjusted life-year gained when compared with no intervention. The results depended on the modelled region, efficacy, pricing, and severity of the RSV season.
• In 2 studies, year-round RSV immunization during pregnancy was not considered cost-effective compared with seasonal RSV prophylaxis with long-acting monoclonal antibodies (mAbs), such as nirsevimab, when the price per dose was the same as that of the long-acting mAb. RSV immunization during pregnancy was estimated to become cost-effective when its acquisition cost per dose was 2 to 5 times lower than that of the long-acting mAb.