COST-EFFECTIVENESS OF MATERNAL BIVALENT RSVPREF VACCINATION AT 32 TO 36 WEEKS' GESTATION FOR THE PREVENTION OF INFANT RESPIRATORY SYNCYTIAL VIRUS LOWER RESPIRATORY TRACT DISEASE IN SINGAPORE
Author(s)
Casuarine Low, PhD, Melvin Wong, BSc, Wan Qing Wong, PhD, Benjamin Ong, BSc, MSc, Mohamed Ismail Abdul Aziz, MSc.
Agency for Care Effectiveness, Ministry of Health, Singapore, Singapore.
Agency for Care Effectiveness, Ministry of Health, Singapore, Singapore.
OBJECTIVES: Respiratory syncytial virus (RSV) is a common cause of lower respiratory tract disease (LRTD) in infants in Singapore. RSVpreF is a bivalent prefusion F protein-based vaccine administered to pregnant individuals conferring infant protection via transplacental transfer of neutralising maternal antibodies. This study evaluates the cost-effectiveness of RSVpreF compared to no immunisation for the prevention of RSV-LRTD in infants in Singapore.
METHODS: A static decision tree model from the Singapore healthcare system’s perspective was conducted over a one-year time horizon, assuming year-round RSV circulation, with a lifetime horizon applied for quality-adjusted life years (QALYs) lost due to RSV-associated premature mortality. The target population comprised infants born to mothers vaccinated at 32 to 36 weeks' gestation, in line with Singapore’s Health Sciences Authority-approved indication. Vaccine efficacy (VE) inputs including medically attended RSV-LRTD and RSV-associated hospitalisation were derived from the 32 to 36 weeks' gestation subgroup of the MATISSE phase 3 trial. Outcomes modelled were RSV-associated hospitalisation and intensive care unit (ICU) stay, RSV-associated outpatient visits, RSV-associated emergency visits and RSV-associated deaths. Health-related quality of life scores were derived from a multi-country infant RSV cohort in Europe. Costs were extracted from published prices and national database (2023-2024) respectively. Sensitivity and scenario analyses were conducted to assess model uncertainties.
RESULTS: Compared to no immunisation, RSVpreF had an incremental cost-effectiveness ratio (ICER) of SGD 328,000 (USD 242,720) per QALY gained. RSVpreF yielded 19.8 incremental QALYs across the modelled population, primarily attributable to reductions in outpatient visits and premature mortality, though the high cost of the vaccine resulted in an elevated ICER. Results were most sensitive to the cost of RSVpreF, vaccine efficacy assumptions, and RSV-associated mortality rates during hospitalisation.
CONCLUSIONS: Our findings showed that RSVpreF could reduce the burden of RSV disease in the infant population, and are consistent with the range of ICERs reported in published literature.
METHODS: A static decision tree model from the Singapore healthcare system’s perspective was conducted over a one-year time horizon, assuming year-round RSV circulation, with a lifetime horizon applied for quality-adjusted life years (QALYs) lost due to RSV-associated premature mortality. The target population comprised infants born to mothers vaccinated at 32 to 36 weeks' gestation, in line with Singapore’s Health Sciences Authority-approved indication. Vaccine efficacy (VE) inputs including medically attended RSV-LRTD and RSV-associated hospitalisation were derived from the 32 to 36 weeks' gestation subgroup of the MATISSE phase 3 trial. Outcomes modelled were RSV-associated hospitalisation and intensive care unit (ICU) stay, RSV-associated outpatient visits, RSV-associated emergency visits and RSV-associated deaths. Health-related quality of life scores were derived from a multi-country infant RSV cohort in Europe. Costs were extracted from published prices and national database (2023-2024) respectively. Sensitivity and scenario analyses were conducted to assess model uncertainties.
RESULTS: Compared to no immunisation, RSVpreF had an incremental cost-effectiveness ratio (ICER) of SGD 328,000 (USD 242,720) per QALY gained. RSVpreF yielded 19.8 incremental QALYs across the modelled population, primarily attributable to reductions in outpatient visits and premature mortality, though the high cost of the vaccine resulted in an elevated ICER. Results were most sensitive to the cost of RSVpreF, vaccine efficacy assumptions, and RSV-associated mortality rates during hospitalisation.
CONCLUSIONS: Our findings showed that RSVpreF could reduce the burden of RSV disease in the infant population, and are consistent with the range of ICERs reported in published literature.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE283
Topic
Economic Evaluation, Health Technology Assessment
Topic Subcategory
Trial-Based Economic Evaluation
Disease
Pediatrics, Vaccines