AN ECONOMIC EVALUATION OF RESPIRATORY SYNCYTIAL VIRUS (RSV) IMMUNISATION FOR INFANTS IN IRELAND
Author(s)
Susan Ahern, PhD, David Byrne, MPH, Lorna English, MPharm, Patricia Harrington, PhD, Rajani Pokharel, PhD, Conor Teljeur, PhD, Mairin Ryan, PhD.
Health Information and Quality Authority, Dublin, Ireland.
Health Information and Quality Authority, Dublin, Ireland.
OBJECTIVES: This study aimed to estimate the cost-utility of an infant-based RSV immunisation programme in Ireland. It was conducted as part of a health technology assessment to inform long-term policy decision-making by the Department of Health.
METHODS: A Markov model was developed to characterise the incidence of medically-attended cases of RSV and estimate the cost-effectiveness of an RSV immunisation programme for infants aged up to 1 year. Conducted from the payer perspective, five alternative seasonal-only and seasonal plus catch-up immunisation strategies, offering an extended half-life monoclonal antibody (EHL-mAb) and or a maternal vaccine, were assessed. Cost-effectiveness was assessed assuming a willingness-to-pay (WTP) threshold of €45,000 per quality-adjusted life year (QALY). Uncertainty was investigated using probabilistic sensitivity analysis and scenario analyses.
RESULTS: The base-case results demonstrated that a seasonal plus catch-up EHL-mAb immunisation strategy resulted in the largest reduction in the annual number of medically-attended RSV cases (43%) and hospitalisations (52%) in those aged up to 1 year. At assumed ex-VAT prices of €301 for the EHL-mAb and €165 for the maternal vaccine, none of the five immunisation strategies assessed were considered cost-effective. Sensitivity analysis indicated that compared with no vaccination, at an ex-VAT price of: a) €166 for the EHL-mAb, the seasonal plus catch-up EHL-mAb strategy would be cost-effective and b) €47 or less for the maternal vaccine and at least €190 for the EHL-mAb, a maternal vaccine-based strategy would be cost-effective.
CONCLUSIONS: An RSV immunisation programme for infants in Ireland would be associated with significant reductions in medically-attended cases and hospitalisations. However, these benefits would come at a high financial cost. In the base-case analysis presented, an RSV immunisation programme for infants was considered not cost-effective at modelled intervention prices at a WTP threshold of €45,000 per QALY.
METHODS: A Markov model was developed to characterise the incidence of medically-attended cases of RSV and estimate the cost-effectiveness of an RSV immunisation programme for infants aged up to 1 year. Conducted from the payer perspective, five alternative seasonal-only and seasonal plus catch-up immunisation strategies, offering an extended half-life monoclonal antibody (EHL-mAb) and or a maternal vaccine, were assessed. Cost-effectiveness was assessed assuming a willingness-to-pay (WTP) threshold of €45,000 per quality-adjusted life year (QALY). Uncertainty was investigated using probabilistic sensitivity analysis and scenario analyses.
RESULTS: The base-case results demonstrated that a seasonal plus catch-up EHL-mAb immunisation strategy resulted in the largest reduction in the annual number of medically-attended RSV cases (43%) and hospitalisations (52%) in those aged up to 1 year. At assumed ex-VAT prices of €301 for the EHL-mAb and €165 for the maternal vaccine, none of the five immunisation strategies assessed were considered cost-effective. Sensitivity analysis indicated that compared with no vaccination, at an ex-VAT price of: a) €166 for the EHL-mAb, the seasonal plus catch-up EHL-mAb strategy would be cost-effective and b) €47 or less for the maternal vaccine and at least €190 for the EHL-mAb, a maternal vaccine-based strategy would be cost-effective.
CONCLUSIONS: An RSV immunisation programme for infants in Ireland would be associated with significant reductions in medically-attended cases and hospitalisations. However, these benefits would come at a high financial cost. In the base-case analysis presented, an RSV immunisation programme for infants was considered not cost-effective at modelled intervention prices at a WTP threshold of €45,000 per QALY.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE603
Topic
Economic Evaluation, Epidemiology & Public Health, Health Technology Assessment
Disease
Pediatrics, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory), Vaccines