OBJECTIVES: Respiratory syncytial virus (RSV) infections pose a significant health burden among adults aged ≥60 years in Austria. International data show an annual incidence of 3-7% in healthy older adults (4-10% for risk groups).

METHODS: A monthly-cycle static Markov model was developed to assess RSVPreF3 OA vaccine impact on adults aged 60-74 years who have underlying medical conditions and adults aged ≥75 years from general population. Analysis was conducted under a healthcare system perspective comparing no-vaccination to a single RSV vaccine dose over a 3-year time horizon. Epidemiological, healthcare resource use and cost data are based on local sources and systematic literature reviews. A 3% discount rate was applied for costs and utilities. Deterministic and probabilistic sensitivity analyses were conducted to evaluate uncertainties.

RESULTS: Vaccinating general population aged ≥75 with 439,447 doses in total, would avert 17,866 RSV-LRTD (lower respiratory tract disease) cases, 3,287 hospitalizations and 408 RSV-related deaths. Moreover, it would lead to a gain of 2,750 quality-adjusted life-years (QALYs) and prevent 14M € direct medical costs over a time horizon of 3 years. The incremental cost-effectiveness ratio (ICER) is estimated at 23,366 €/QALY gained. Twenty-five individuals would need to be vaccinated to prevent one RSV-LRTD case.

Vaccinating high-risk population aged 60-74 with 402,528 doses in total would avert 17,107 RSV-LRTD cases, 3,171 hospitalizations and 160 RSV-related deaths. Moreover, it would lead to a gain of 2,219 QALYs and prevent 9M € direct medical costs. The ICER was estimated at 28,067 €/QALY gained. Twenty-four individuals would need to be vaccinated in order to prevent one RSV-LRTD case.

CONCLUSIONS: Comparing the ICER to the WHO's willingness-to-pay threshold of €49,500 per QALY (one Austrian GDP per capita), vaccinating adults 75+ with RSV PreF3 OA and adults 60-74 with underlying medical conditions is cost-effective and can reduce the RSV burden in Austria.

Funding: GSK (VEO-000930).