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Infectious Diseases

Poster Session 2

(431) Examining the Cost-Effectiveness of the RSV Vaccination in Pregnancy

Tuesday, February 13, 2024
3:30 PM – 5:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective:

Respiratory syncytial virus (RSV) causes severe infections in neonates at increasing rates. A new vaccine has been shown to increase health benefits for neonates if given during pregnancy. We examined the cost-effectiveness associated with vaccinating all pregnant patients against influenza.

Study Design:

We designed a cost-effectiveness model using TreeAge to compare outcomes in pregnant patients who received the RSV vaccine to those who did not. We used a theoretical cohort of 3,661,220 the number of births in the United States in 2022. While RSV is a seasonal disease, we assumed that all patients would have an equal risk of RSV in the neonate as we examined the rate of infection within the first 6 months of life. Our outcomes included RSV infections in neonates, severe RSV infections requiring hospitalization, infant death due to RSV, and asthma incurred from RSV infection in addition to cost and quality-adjusted life years (QALYs). Probabilities, costs, and utilities were derived from the literature, and QALYs generated at a discount rate of 3%. Sensitivity analyses were performed to assess the robustness of our model.

Results:

For a one-year theoretical cohort of 3,661,220 patients, the RSV vaccine resulted in a decrease of 63,382 RSV infections, 45,325 of which required hospitalizations. Furthermore, the RSV vaccine resulted in 4 fewer infant deaths and 3,399 fewer cases of asthma before the age of 5. Vaccination resulted in an increased cost of $52 million and increased QALYs by 20,998 leading to an incremental cost-effectiveness ratio (ICER) of $24,679/QALY. In addition, we used sensitivity analysis to vary the cost of the vaccine—currently estimated to be around $280. If the cost of the vaccine was under $140, the vaccine would additionally be cost-saving.

Conclusion:

In our cohort, the RSV vaccine was strongly cost-effective. Our study indicates that providers should recommend that pregnant patients receive an RSV vaccine.