Cost-Effectiveness of Respiratory Syncytial Virus Vaccines for Adults

Three economic evaluations and 1 summary of economic evaluations were identified that assessed the cost-effectiveness of 2 respiratory syncytial virus (RSV) vaccines of interest (RSVPreF3 [Arexvy] and RSVpreF [Abrysvo]) compared with no intervention in older adults residing in high-income countries. No economic evaluations assessing mRNA-1345 were identified. No publications investigating RSV vaccination in adults aged 59 years or younger were identified. In total, 5 economic evaluations for RSV vaccines in adults were identified. Four economic evaluations were conducted in the US and 1 was conducted in Hong Kong. All results were presented in terms of incremental cost-utility ratios (i.e., incremental cost per quality-adjusted life-years gained). Net cost per outcome averted was reported for 1 economic evaluation, and cost per hospitalization averted was reported for 3 economic evaluations. The results of all publications found that RSVPreF3 (Arexvy) and RSVpreF (Abrysvo) were more costly and more effective than no intervention for RSV-associated disease. All publications reported that vaccinating older adults against RSV disease was potentially cost-effective. All publications noted that the cost-effectiveness was dependent on vaccine cost, vaccine efficacy, the waning of vaccine protection, RSV hospitalization incidence, health care unit costs, and respective regional willingness-to-pay thresholds. The generalizability of the identified economic evaluations may be limited because the study settings were notably different from Canada. To estimate the cost-effectiveness of RSV vaccinations in Canada, a de novo economic evaluation conducted from a Canadian setting comparing RSVPreF3 (Arexvy), RSVpreF (Abrysvo), and mRNA-1345 is required.