ECONOMIC IMPACT OF RSV MATERNAL IMMUNIZATION [RSVPREF] IN THE DOMINICAN REPUBLIC: A COST-UTILITY ANALYSIS
Author(s)
Jaime Ordoñez, MEd, PhD1, Juan José Baldi-Castro, MSc, PharmD2, Andreina J. Alamo, BSc3, Rita Rojas, MD4, Sandra Orsini, MD5, Leo Alejandro Barrantes, MSc, PharmD2, Manuel Colomé-Hidalgo, MD6.
1TrueConsulting, Medellín, Colombia, 2Pfizer Inc., Escazú, Costa Rica, 3Pfizer SAS, Bogotá, Colombia, 4Plaza de la Salud General Hospital, Pedro Henríquez Ureña National University, Santo Domingo, Dominican Republic, 5Dr. Robert Reid Cabral Pediatric Hospital, Santo Domingo, Dominican Republic, 6Autonomous University of Santo Domingo, Santo Domingo, Dominican Republic.
1TrueConsulting, Medellín, Colombia, 2Pfizer Inc., Escazú, Costa Rica, 3Pfizer SAS, Bogotá, Colombia, 4Plaza de la Salud General Hospital, Pedro Henríquez Ureña National University, Santo Domingo, Dominican Republic, 5Dr. Robert Reid Cabral Pediatric Hospital, Santo Domingo, Dominican Republic, 6Autonomous University of Santo Domingo, Santo Domingo, Dominican Republic.
OBJECTIVES: The objective of this analysis was to evaluate the cost-utility of the respiratory syncytial virus prefusion F (RSVpreF) maternal vaccine among infants in the Dominican Republic.
METHODS: A population-based Markov model compared maternal immunization with RSVpreF and no intervention among infants in the Dominican Republic. The model estimated health outcomes and costs over a lifetime horizon from the perspective of the Dominican healthcare system. Health states included outpatient care, hospitalization, and death. Epidemiological data were extracted from Latin American and National studies. Clinical effectiveness, utilities, and costs were derived from clinical trials, published literature, and national databases. Vaccine uptake was estimated at 57%, based on the maternal influenza uptake reported by WHO, and the price was obtained from PAHO's price list. Costs were reported in 2025 US dollars using an exchange rate of 63.5 Dominican pesos. A willingness-to-pay threshold of one gross-domestic-product per capita was applied (USD 10.875). Uncertainty was assessed using one-way and probabilistic sensitivity analyses, and a scenario analysis is presented to assess variations in vaccine uptake.
RESULTS: During the first year of life, maternal vaccination with RSVpreF was projected to prevent 4,707 RSV cases compared with no vaccination. This included 532 avoided hospitalizations, 1,521 fewer emergency department visits, and 2,654 outpatient consultations. The intervention was also estimated to avert seven neonatal deaths, corresponding to gains of 230 quality-adjusted life-years. RSVpreF maternal immunization resulted in savings of USD 3.87 million and an ICER of 4.890 per QALY gained. Sensitivity analysis highlights the influence of vaccine pricing and RSV hospitalization rates on the results. Scenario analysis reveals that increasing vaccine uptake will reduce RSV burden about 27%.
CONCLUSIONS: At PAHO-referenced prices, RSVpreF maternal vaccination was a cost-effective strategy for the Dominican health care system. The intervention could substantially prevent RSV-related morbidity, improve infant health outcomes, and lower healthcare costs.
METHODS: A population-based Markov model compared maternal immunization with RSVpreF and no intervention among infants in the Dominican Republic. The model estimated health outcomes and costs over a lifetime horizon from the perspective of the Dominican healthcare system. Health states included outpatient care, hospitalization, and death. Epidemiological data were extracted from Latin American and National studies. Clinical effectiveness, utilities, and costs were derived from clinical trials, published literature, and national databases. Vaccine uptake was estimated at 57%, based on the maternal influenza uptake reported by WHO, and the price was obtained from PAHO's price list. Costs were reported in 2025 US dollars using an exchange rate of 63.5 Dominican pesos. A willingness-to-pay threshold of one gross-domestic-product per capita was applied (USD 10.875). Uncertainty was assessed using one-way and probabilistic sensitivity analyses, and a scenario analysis is presented to assess variations in vaccine uptake.
RESULTS: During the first year of life, maternal vaccination with RSVpreF was projected to prevent 4,707 RSV cases compared with no vaccination. This included 532 avoided hospitalizations, 1,521 fewer emergency department visits, and 2,654 outpatient consultations. The intervention was also estimated to avert seven neonatal deaths, corresponding to gains of 230 quality-adjusted life-years. RSVpreF maternal immunization resulted in savings of USD 3.87 million and an ICER of 4.890 per QALY gained. Sensitivity analysis highlights the influence of vaccine pricing and RSV hospitalization rates on the results. Scenario analysis reveals that increasing vaccine uptake will reduce RSV burden about 27%.
CONCLUSIONS: At PAHO-referenced prices, RSVpreF maternal vaccination was a cost-effective strategy for the Dominican health care system. The intervention could substantially prevent RSV-related morbidity, improve infant health outcomes, and lower healthcare costs.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE408
Topic
Economic Evaluation
Disease
SDC: Pediatrics, STA: Vaccines