BACKGROUND: In the elderly the burden of Respiratory Syncytial Virus (RSV) resembles that of influenza, and may even be considered worse due to the lack of a (preventive) treatment.

OBJECTIVES: To identify the available literature on RSV infection in elderly, and to provide updated exploratory results of the cost-effectiveness of an RSV vaccine in the Netherlands and the UK.

METHODS: A literature search was performed in Medline and EMBASE on April 2, 2019 using the search terms: ‘Respiratory Syncytial Virus’, ‘Human’, ‘Elderly’ and ‘Vital Statistics’. The results served as inputs for a static decision tree model used to estimate the economically justifiable price (EJP) for an RSV vaccine based on different willingness-to-pay thresholds (WTP). The WTPs were set on €20,000 and €50,000 per QALY in the Netherlands, and £15,000 and £30,000 per QALY in the UK, while in the analyses the social perspective was chosen for the Netherlands and the third-party payer perspective for the UK. In the sensitivity analyses the robustness of the results were tested and various additional scenario analyses were conducted.

RESULTS: After screening titles, abstracts and full-text papers only three (out of sixteen) studies for the Netherlands and six (out of 25) studies for the UK remained. In the base case analysis for the Netherlands (mean incidence: 3.4%; Vaccine Efficacy (VE):50%), EJPs of €5.36 (95% CI, -0.09-16.95) and €21.27 (95% CI, 9.05-45.62) were found for the acquisition costs, corresponding with the lower and higher WTP respectively. In the base case analysis for the UK (mean incidence: 6.6%; VE:50%), EJPs of £16.53 (95% CI, 7.67-27.5) and £42.72 (95% CI, 24.90-65.76) were found for the acquisition costs corresponding the lower and higher WTP respectively.

CONCLUSIONS: An RSV vaccine may be cost-effective in both the Netherlands and the UK, depending on the VE, vaccine price and the RSV incidence.