Disease Burden Estimates in Economic Evaluation Studies of Respiratory Syncytial Virus (RSV) Maternal Immunization: A Systematic Review
Author(s)
Sophia Borges, MD-PhD Candidate1, Natacha Cerchiari, MSc, MD1, Erick Polli, MSc1, Ana Carolina Nonato, MSc, MD1, Felipe Barreto, Medical Student1, Alexandre Esteves, Medical Student1, Maarten J. Postma, PhD2, Ana Marli Sartori, MD, PhD3, Patricia de Soarez, MPH, PhD4;
1Faculdade de Medicina da Universidade de Sao Paulo FMUSP, São Paulo, Brazil, 2Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, Netherlands; Department of Economics, Econometrics & Finance, University of Groningen, Faculty of Economics & Business, Groningen, Netherlands; Ce, Groningen, Netherlands, 3Departamento de Infectologia e Medicina Tropical, Faculdade de Medicina da Universidade de Sao Paulo FMUSP, São Paulo, Brazil, 4Departamento de Medicina Preventiva, Faculdade de Medicina da Universidade de Sao Paulo FMUSP, São Paulo, Brazil
1Faculdade de Medicina da Universidade de Sao Paulo FMUSP, São Paulo, Brazil, 2Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, Netherlands; Department of Economics, Econometrics & Finance, University of Groningen, Faculty of Economics & Business, Groningen, Netherlands; Ce, Groningen, Netherlands, 3Departamento de Infectologia e Medicina Tropical, Faculdade de Medicina da Universidade de Sao Paulo FMUSP, São Paulo, Brazil, 4Departamento de Medicina Preventiva, Faculdade de Medicina da Universidade de Sao Paulo FMUSP, São Paulo, Brazil
Presentation Documents
OBJECTIVES: Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract infections in young children, yet effective treatments remain unavailable. Maternal immunization has recently emerged as a promising strategy to protect newborns from RSV. Accurate epidemiological data are critical for health economic evaluations (HEE). This systematic review assesses how HEE of RSV maternal vaccination (MV) estimate disease burden, focusing on methods and data sources.
METHODS: A systematic search was conducted in MEDLINE, SCOPUS, EMBASE, NHS EED, HTA, Tufts CEA Registry, LILACS, and Web of Science to identify full HEE of RSV maternal immunization published since 2000. Reporting quality was assessed using the CHEERS 2022 checklist, and a descriptive, interpretive synthesis of the data was performed. This systematic review protocol is registered in PROSPERO (CRD42024549989).
RESULTS: All 21 included studies were cost-utility analyses, with 10 conducted in high-income countries (HICs). Hospitalization national data were the most accessible, while outpatient care data required diverse estimation methods. Recent studies have adopted age-specific estimates for the first year of life, as opposed to aggregated incidence approach for children under five years old. Only studies conducted in low- and middle-income countries (LMICs) considered out-of-hospital deaths, while some HIC studies excluded RSV-related mortality, citing uncertainties about prevention. No study included equity assessments. Most studies (18/21) indicated that MV could be cost-effective at certain dose prices, with seasonal strategies demonstrating higher cost-effectiveness than to year-round approaches.
CONCLUSIONS: This study highlights methodological challenges in HEE of RSV MV strategies, particularly in LMICs, where the burden of disease is highest yet local data and HEE remain limited. Issues such as estimating outpatient care rates and reliance on non-local data, underscore the need for strengthened respiratory virus surveillance and local data inputs. Addressing these gaps will enhance the accuracy and reliability of the HEE, enabling evidence-based policies to improve RSV prevention globally.
METHODS: A systematic search was conducted in MEDLINE, SCOPUS, EMBASE, NHS EED, HTA, Tufts CEA Registry, LILACS, and Web of Science to identify full HEE of RSV maternal immunization published since 2000. Reporting quality was assessed using the CHEERS 2022 checklist, and a descriptive, interpretive synthesis of the data was performed. This systematic review protocol is registered in PROSPERO (CRD42024549989).
RESULTS: All 21 included studies were cost-utility analyses, with 10 conducted in high-income countries (HICs). Hospitalization national data were the most accessible, while outpatient care data required diverse estimation methods. Recent studies have adopted age-specific estimates for the first year of life, as opposed to aggregated incidence approach for children under five years old. Only studies conducted in low- and middle-income countries (LMICs) considered out-of-hospital deaths, while some HIC studies excluded RSV-related mortality, citing uncertainties about prevention. No study included equity assessments. Most studies (18/21) indicated that MV could be cost-effective at certain dose prices, with seasonal strategies demonstrating higher cost-effectiveness than to year-round approaches.
CONCLUSIONS: This study highlights methodological challenges in HEE of RSV MV strategies, particularly in LMICs, where the burden of disease is highest yet local data and HEE remain limited. Issues such as estimating outpatient care rates and reliance on non-local data, underscore the need for strengthened respiratory virus surveillance and local data inputs. Addressing these gaps will enhance the accuracy and reliability of the HEE, enabling evidence-based policies to improve RSV prevention globally.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE514
Topic
Economic Evaluation
Disease
SDC: Pediatrics, SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory), STA: Vaccines