OBJECTIVES: Respiratory syncytial virus (RSV) infections are one of the leading causes of lower respiratory tract disease (LRTD) among adults aged ≥60 years in Europe, causing severe bronchitis or pneumonia, conditions that may require hospitalization. Data in Europe show an annual incidence of 4–7% due to seasonal variations in older adults.

METHODS: A monthly-cycle static Markov model was developed to assess RSVPreF3 OA vaccine impact on adults ≥75 years and on adults 60–74 years with at least one underlying medical condition, in line with national recommendations. The analysis was performed from the healthcare system perspective, comparing no vaccination to a single dose of the RSVPreF3 OA vaccine over a three-year period. Epidemiological and health care resource use data were derived from available public references. Costs and utilities were discounted at a rate of 3%. The incremental cost-effectiveness ratio (ICER) was calculated and evaluated on a willingness-to-pay (WTP) threshold of 500,000 SEK per quality-adjusted life year (QALY). Deterministic and probabilistic sensitivity analyses were also conducted to assess the robustness of the results.

RESULTS: Vaccinating adults 75+, with 839,257 doses in total, would avert 36,857 RSV-LRTD cases, 8,133 hospitalizations and 892 RSV-related deaths. Moreover, it would lead to a gain of 6,041 QALYs. The ICER was estimated at 291,768/QALY gained. Vaccinating adults 60–74 with at least one underlying condition, with 217,618 doses in total, would avert 10,749 RSV-LRTD cases, 1,311 hospitalizations and 144 RSV-related deaths. Moreover, it would lead to a gain of 1,966 QALYs and prevent 62 million SEK direct medical costs. The ICER was estimated at 250,639/QALY gained.

CONCLUSIONS: The RSV strategy is therefore cost-effective at a WTP of 500,00 SEK/QALY in both population studies, compared to no vaccination and can reduce the burden of RSV in Sweden.