Cost-Effectiveness Analysis of RSVpreF Maternal Vaccine for RSV Prevention in Infants Under Situation of the National Vaccination Program in Taiwan: A Study on Economic and Clinical Advantages

OBJECTIVES: RSV(respiratory syncytial virus), the main reason for infant hospitalizations in Taiwan, reports 1,000 to 3,000 annual cases and occurs throughout the year.^[1] We aim to assess the clinical benefits and cost-effectiveness of a new RSV vaccine for maternal immunization under the situation of national vaccination program.

METHODS: A global Markov model was adapted to evaluate the cost-effectiveness of maternal vaccination versus no intervention in preventing RSV infection in infants from birth to age 1, from a healthcare system perspective. The “MATISSE” clinical trial data informed the vaccine’s effectiveness, public data was used to determine model parameters, and a 50% vaccine uptake was presumed, mirroring Taiwan’s influenza vaccination rates. Costs and utilities were discounted at 3% annually. Sensitivity and scenario analyses were conducted to test uncertainties arising from the input values.

RESULTS: With a 50% vaccination uptake, the program can avoid 883 hospitalizations, 204 emergency department care, and 2126 outpatient visits, also prevent 2 deaths due to RSV infections. The analysis revealed that the additional cost of vaccine- TWD 414.82M, could increase life years by 51 and quality-adjusted life years(QALY) by 73 compared to no vaccination. This results in an Incremental Cost-Effectiveness Ratio (ICER) of 2,265,981 per QALY gained, falling within 3x Taiwan’s GDP per capita. OWSA demonstrated ICERs ranging from NTD 1,096,297 to 3,825,609. The scenarios resulted in a reduction of hospitalizations from 353 to 1412 cases, with the uptake rate increasing from 20% to 80% respectively.

CONCLUSIONS: The study finds the RSVpreF maternal vaccine to be cost-effective and clinical beneficial for infant RSV infections under Taiwan’s national vaccination program.

[1] Lee PI, Liu CC, Hu YL, Chen JM. Seasonality and risk factor analysis of respiratory syncytial virus infection in children in Taiwan-A retrospective study from 1995 to 2005. J Med Virol 2023;95(10):e29116.