Economic and Clinical Benefits of Bivalent Respiratory Syncytial Virus Prefusion F (RSVpreF) Maternal Vaccine for Prevention of RSV in Infants: A Cost-Effectiveness Analysis for Mexico

OBJECTIVES: Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract illness (LRTI) among infants in Mexico. Targeted treatment is currently unavailable, and access to prophylactic passive immunization is limited to infants with high-risk conditions, leaving most infants unprotected. A novel RSVpreF vaccine for use among pregnant women for the prevention of RSV in infants is expected to be licensed in Mexico. Hence, the clinical and economic burden of RSV-LRTI among infants in Mexico, with and without a year-round RSVpreF maternal vaccination program, was estimated.

METHODS: A population-based cohort model was used to project clinical and economic outcomes of RSV from birth to 1 year of age for RSVpreF vaccine compared to no intervention. Model parameter values were derived from publicly available data. Vaccine effectiveness was based on “MATISSE” clinical trial efficacy data; vaccine uptake (60%) was assumed to be equivalent to maternal tetanus/diphtheria/pertussis vaccination rates in Mexico. Analyses were conducted from the healthcare system perspective, with direct costs (2024 MXN$) and outcomes discounted at 5% annually; scenario and sensitivity analyses tested the robustness of model settings and inputs.

RESULTS: With no intervention, there were 48,212 RSV hospitalizations, 14,516 RSV cases requiring emergency department (ED) care, and 23,674 RSV cases requiring a physician office (PO) visit; the corresponding total economic costs were MXN$4.85 billion per year. Assuming 60% uptake, year-round RSVpreF administered to 1,891M pregnant women would prevent 15,771 hospitalizations, 3,376 ED cases, and 5,507 PO cases. With 532 quality-adjusted life years gained, RSVpreF averts MXN$1,746M in direct medical costs. Assuming a cost-effectiveness threshold equivalent of 1x-3xGDP per capita in Mexico, RSVpreF would be cost-saving at up to MXN$1,294/dose and cost-effective up to MXN$1,403–MXN$1,620/dose.

CONCLUSIONS: Year-round RSVpreF maternal vaccination would substantially reduce RSV’s clinical and economic burden among infants in Mexico and likely be a cost-saving program.