Clinical and economic benefits of bivalent respiratory syncytial virus prefusion F (RSVpreF) maternal vaccine for prevention of RSV illness in infants: A cost-effectiveness analysis for Singapore.

BACKGROUND

Respiratory syncytial virus (RSV) is a leading cause of respiratory tract infections in children. A novel bivalent RSV prefusion F protein subunit (RSVpreF) vaccine has recently been approved by the Health Sciences Authority (HSA) in Singapore. This study estimated the clinical and economic impact of a year-round RSVpreF maternal vaccination program on the prevention of RSV among infants in Singapore.

METHODS

A Markov cohort model was used to project clinical and economic outcomes of RSV from birth to one year of age for RSVpreF vaccine compared to no intervention. Analyses were conducted from the healthcare system perspective, with direct costs (2025 Singapore dollars [S$]) and outcomes discounted at 3% annually; scenario and sensitivity analyses tested the robustness of the model.

FINDINGS: Compared to no intervention, a year-round RSVpreF program with 80% coverage would prevent 308 hospitalizations and 1995 outpatient visits annually, averting S$2.15 million in direct medical costs and saving 29 quality-adjusted life years (QALYs). The RSVpreF vaccine would be cost-effective up to S$237.68/dose under a cost-effectiveness threshold of 1 x gross domestic product per capita (S$121,378) per QALY gained.

INTERPRETATION: Year-round RSVpreF maternal vaccination would help reduce pressures on the healthcare system as well as reduce RSV's clinical and economic burden among infants in Singapore, and likely be a cost-effective program.