Abstract
Respiratory syncytial virus (RSV) is a common cause of acute respiratory illness in individuals of all ages, with adults aged ≥60 years and adults with certain chronic conditions at increased risk of severe RSV-related outcomes. This study evaluates the cost-effectiveness of the adjuvanted RSVPreF3 vaccine versus no vaccine in adults aged ≥60 years in the United States (US). A multi-cohort Markov model was developed with a 5-year time horizon and 1-month cycle length to compare outcomes for no vaccination and one-time adjuvanted RSVPreF3 vaccination (assuming the same vaccination as for influenza vaccines). Clinical parameters (e.g., vaccine efficacy) were based on phase 3 clinical trial data over 3 seasons, with all other inputs obtained from public US sources and scientific literature. Outcomes included total and incremental quality-adjusted life year (QALY) losses and costs, as well as incremental cost-effectiveness ratios (ICERs). Sensitivity analyses were conducted to evaluate the sensitivity of results to inputs. In the base case, the model estimated that vaccinating 52.7 million adults aged ≥60 years with the adjuvanted RSVPreF3 vaccine once would result in 244,424 fewer QALY losses and an incremental societal cost of $4.5 billion over 5 years, with vaccination costs partially offset by reduced disease-related costs. From the societal perspective, adjuvanted RSVPreF3 vaccination resulted in an ICER of $18,430 per QALY gained. Results were relatively robust across sensitivity analyses and indicate that adjuvanted RSVPreF3 vaccination is a cost-effective option for the prevention of RSV in US adults aged ≥ 60 years, reducing the substantial burden within this population.