OBJECTIVES: Respiratory syncytial virus (RSV) is an important causative pathogen of lower respiratory tract disease (LRTD) among adults, and can lead to significant morbidity and mortality, especially among older adults and those with certain medical conditions. RSVpreF, Pfizer’s novel RSV vaccine, was recently approved by Health Canada to prevent RSV-LRTD in adults aged ≥60 years. We projected the potential public health impact of RSVpreF use among adults aged 60-99 years in Canada.

METHODS: Clinical outcomes and economic costs of RSV-LRTD with use of RSVpreF and, alternatively, no intervention were evaluated over 3 years using a cohort model with Markov-type process. Model inputs were estimated using data from Canada-specific published sources, with data from other comparable countries and unpublished sources, as needed. Uptake of RSVpreF varied by age (60-74y: 48.3%; 75-99y: 65.4%). RSVpreF was assumed protective for two years, with some waning; effectiveness was derived from Phase III trial (“RENOIR”) data. Clinical outcomes included RSV-LRTD requiring hospitalization, emergency department (ED), or physician office/hospital outpatient (PO/HO) care, and death due to RSV-LRTD. Direct (i.e., medical care) and indirect (i.e., morbidity/mortality-related work loss) costs were calculated based on expected cases and corresponding unit costs, with annual 1.5% discounting.

RESULTS: Without use of RSVpreF among adults aged 60-99 years (N=9.6M), there would be 49,199 cases of hospitalized RSV-LRTD, 36,926 cases of RSV-LRTD requiring ED care, 433,414 cases of RSV-LRTD requiring PO/HO care, and 5,092 RSV-related deaths. Corresponding total disease-related costs would be $1.3 billion (direct: $918.7M; indirect: $338.5M). Use of RSVpreF is projected to prevent 14,569 hospitalizations, 10,683 cases requiring ED care, 92,753 cases requiring PO/HO care, and 1,555 deaths, yielding $354.7 million in total savings (direct: $267.2M; indirect: $87.5M).

CONCLUSIONS: Findings suggest use of RSVpreF among adults aged ≥60 years in Canada will considerably reduce the clinical and economic burden of RSV-LRTD.