OBJECTIVES: The objective of the present study was to evaluate the cost-effectiveness of maternal immunization with Bivalent Respiratory Syncytial Virus Stabilized Prefusion F (RSVpreF) vaccine for the prevention of respiratory syncytial Virus (RSV) among infants in Greece

METHODS: A Markov model was adapted from public payer’s perspective to depict the health and economic outcomes of RSV from birth to 1 year of age. Epidemiology, vaccine’s efficacy, utilities, and direct medical costs’ (prices, €2024) data were obtained from published literature and official sources. Model outcomes included number of medically attended RSV cases, stratified by care setting (i.e., hospital, emergency department [ED], outpatient visit [OV]), and attributable RSV-related deaths, life years (LY), & quality-adjusted life-years (QALY) gained, costs, and incremental cost-effectiveness ratios (ICERs) of RSVpreF vaccination compared to no vaccination.

RESULTS: The model analysis projected that without RSV vaccination there would be 4,884 hospitalizations, 7,155 ED encounters, 9,896 OV and 11 deaths related to RSV among Greek infants resulting in direct medical costs of €25.87million. Year-round RSVpreF vaccination with 19.5% coverage, was projected to reduce hospitalizations by 484, ED encounters by 335, OV by 339 and deaths by 1. The vaccine effectiveness benefits translate in RSVpreF accruing 31 additional QALYs compared with no vaccination strategy. Combining health and economic outcomes, the incremental analysis showed that RSVpreF was estimated to be a cost-effective vaccination strategy and resulted in ICERs of €12,082 per LY gained, €8,280 per QALY gained and €528 per RSV hospitalized case avoided compared to no vaccination.

CONCLUSIONS: The maternal RSVpreF vaccination, providing protection from the first day of life, has the potential to significantly reduce RSV-related disease in infancy. The present study indicated that the maternal RSVpreF vaccination was estimated to be a cost-effective option compared to no intervention from the payer perspective, demonstrating its value as an RSV preventive strategy.