Impact of Maternal Vaccination Strategy on RSV-Related Hospital Burden Among Infants Aged Less Than One Year in France: A Cost-Effectiveness Analysis
Author(s)
Yasmine Fahfouhi, MSc1, Stephane Fievez, PhD1, Robert Cohen, Md2, Corinne Levy, Md2, Marta Nunes, Md3, Louis Chillotti, PharmD4, Romain Philippe Moreau, PharmD5, William Greenwood, Md1, Emmanuelle Blanc, PhD1, Maud beillat, PhD6, Amy Law, MS, PharmD7.
1Pfizer, Paris, France, 2ACTIV, Créteil, France, 3Center of Excellence in Respiratory Pathogens (CERP), Hospices Civils de Lyon (HCL), Lyon, France, 4Cytel, Oullins, France, 5stève consultants, Angers, France, 6PFIZER FRANCE, PARIS, France, 7Pfizer, New York, NY, USA.
1Pfizer, Paris, France, 2ACTIV, Créteil, France, 3Center of Excellence in Respiratory Pathogens (CERP), Hospices Civils de Lyon (HCL), Lyon, France, 4Cytel, Oullins, France, 5stève consultants, Angers, France, 6PFIZER FRANCE, PARIS, France, 7Pfizer, New York, NY, USA.
OBJECTIVES: Respiratory syncytial virus (RSV) is the main cause of severe lower respiratory tract infections (sLRTI) among infants <1 year. French 2024 guidelines recommend maternal RSV vaccination at 32-36 weeks gestation, from September to January. This study assessed the impact of this recommendation and broader strategies on RSV-related hospital burden reduction.
METHODS: A three-state Markov model (susceptible, RSV-hospitalization, death) compared 4 scenarios: no-vaccination, five-months (current recommendations), nine-months (May-January) and year-round (YR) maternal vaccination. A cohort of 627,499 pregnant women (2023 French census) was modeled over one year. MATISSE trial data were used for medically attended sLRTI vaccine effectiveness (VE - 88%), waning to 53.9% at 6 months, declining to 0% at 9 months. Hospitalization inputs (ICU admissions, length of stay, costs from a healthcare payer perspective) came from French real-world hospital database study. Vaccination coverage was assumed at 65%, with associated costs included (acquisition, dispensation).
RESULTS: Using 2016-2020 incidence data and without vaccination, 38,625 RSV-related hospitalizations were projected (148,761 hospitalization days), with 10,551 ICU admissions, for a total cost of 120M€, annually. The recommended strategy prevented 7,620 (−19.7%) hospitalizations, 34,534 (-23.2%) hospitalization days, 2,617 (-24.8%) ICU admissions, and reduced hospital costs by 24.7M€ (−21%) versus no vaccination, for a total cost of 126.5M€, annually. Compared to the recommended strategy, the 9-month strategy prevented 4,111 (−13.3%) additional hospitalizations and 1,085 (-13.7%) ICU admissions, leading to 12.7M€ in hospital savings, for a total cost increase of 8.0M€ (+6.3%). The YR strategy prevented 5,417 (−17.5%) hospitalizations and 1,383 (-17.4%) ICU admissions (16.7M€ savings), for a 29.9M€ (+23.6%) cost increase versus recommended strategy. Sensitivity analysis using post-COVID (2022-2023) rates showed similar results.
CONCLUSIONS: Higher maternal RSV vaccination coverage could considerably reduce infant hospitalization burden. Broader vaccination strategies offer further reductions in hospitalizations with limited additional cost, associated with an easing of RSV-related healthcare system strain.
METHODS: A three-state Markov model (susceptible, RSV-hospitalization, death) compared 4 scenarios: no-vaccination, five-months (current recommendations), nine-months (May-January) and year-round (YR) maternal vaccination. A cohort of 627,499 pregnant women (2023 French census) was modeled over one year. MATISSE trial data were used for medically attended sLRTI vaccine effectiveness (VE - 88%), waning to 53.9% at 6 months, declining to 0% at 9 months. Hospitalization inputs (ICU admissions, length of stay, costs from a healthcare payer perspective) came from French real-world hospital database study. Vaccination coverage was assumed at 65%, with associated costs included (acquisition, dispensation).
RESULTS: Using 2016-2020 incidence data and without vaccination, 38,625 RSV-related hospitalizations were projected (148,761 hospitalization days), with 10,551 ICU admissions, for a total cost of 120M€, annually. The recommended strategy prevented 7,620 (−19.7%) hospitalizations, 34,534 (-23.2%) hospitalization days, 2,617 (-24.8%) ICU admissions, and reduced hospital costs by 24.7M€ (−21%) versus no vaccination, for a total cost of 126.5M€, annually. Compared to the recommended strategy, the 9-month strategy prevented 4,111 (−13.3%) additional hospitalizations and 1,085 (-13.7%) ICU admissions, leading to 12.7M€ in hospital savings, for a total cost increase of 8.0M€ (+6.3%). The YR strategy prevented 5,417 (−17.5%) hospitalizations and 1,383 (-17.4%) ICU admissions (16.7M€ savings), for a 29.9M€ (+23.6%) cost increase versus recommended strategy. Sensitivity analysis using post-COVID (2022-2023) rates showed similar results.
CONCLUSIONS: Higher maternal RSV vaccination coverage could considerably reduce infant hospitalization burden. Broader vaccination strategies offer further reductions in hospitalizations with limited additional cost, associated with an easing of RSV-related healthcare system strain.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE536
Topic
Economic Evaluation
Disease
Vaccines