At a cost-effectiveness threshold of $95,000 per quality-adjusted life-year (QALY), the prefusion F protein-based vaccines Arexvy and Abrysvo would provide direct health benefits by reducing outcomes associated with respiratory syncytial virus (RSV) infections among older adults in the U.S., a study shows. “Additional evidence of vaccine effectiveness at the population level would be required to alleviate uncertainty on longer-term health benefits and cost-effectiveness of vaccination beyond a single RSV season,” the authors conclude.
The cost-effectiveness analysis considered ambulatory care, hospitalization, and death for adults aged 60 years or older. Based on the net monetary benefit and using a range of prices per dose (PPD), the analysis showed the following from a societal perspective: “Using a willingness-to-pay of $95,000 per QALY gained, we found that vaccination programs could be cost-effective for a PPD up to $127 with Arexvy and $118 with Abrysvo over the first RSV season. Achieving an influenza-like vaccination coverage of 66% for the population of older adults in the United States, the budget impact of these programs at the maximum PPD ranged from $6.48 to $6.78 billion. If the benefits of vaccination extend to a second RSV season as reported in clinical trials, we estimated a maximum PPD of $235 for Arexvy and $245 for Abrysvo, with 2-year budget impacts of $11.78 and $12.25 billion, respectively.”