Presentation (CTI)

OBJECTIVES: Respiratory syncytial virus (RSV) is a major cause of severe lower respiratory tract infections in infants, often requiring hospitalization and intensive care. Preventive strategies such as maternal immunization have been evaluated to reduce RSV-related morbidity and mortality. The objective of this present work was to estimate the cost-utility of maternal RSV vaccination compared to no vaccination in preventing severe RSV outcomes in infants in the Brazilian public healthcare system (SUS) perspective.
METHODS: A decision-tree model was constructed with a one-year time horizon to reflect the acute nature of RSV disease. Vaccine effectiveness was derived from the MATISSE trial, and probabilities of hospitalization (ward and ICU) were obtained from national health data (DATASUS). Direct medical costs were estimated through micro costing study conducted in a public hospital in Brazil, including ward and ICU admissions. Health-state utilities were sourced from the literature, applying disutility during episodes of illness and recovery. Results were expressed as incremental cost-effectiveness ratio (ICER) per quality-adjusted life year (QALY) considering the BRL 40,000/QALY gained threshold adopted by Brazilian government. Deterministic and probabilistic sensitivity analyses (DSA/PSA) were also conducted.
RESULTS: In the base case, maternal RSV vaccination resulted in an incremental cost of BRL 65.28 per pregnant woman and generated QALY gains, yielding an ICER of BRL 7,981.04/QALY, i.e. cost-effective compared to no vaccination at the threshold employed. In both the DSA e PSA, maternal RSV vaccination remained cost-effective as in the base case scenario.
CONCLUSIONS: Maternal RSV vaccination is highly cost-effective in Brazil under an acute-phase, one-year horizon model. These findings supported its inclusion into the Brazil’ NIP in February 2025 as an effective strategy to reduce RSV-related morbidity and healthcare burden in infants.