OBJECTIVES: Several vaccine and antibody products have been available to prevent RSV infections in the general infant population. Little is known about their value for money. This study aims to estimate the cost-effectiveness of Abrysvo and Beyfortus compared to no intervention in United States (US).

METHODS: A Markov model was used to estimate the clinical and economic consequences of Abrysvo, Beyfortus, and no intervention over the first year of life. Interventions were given at the beginning of RSV season. Clinical trial data were used to estimate efficacy against both inpatient and outpatient RSV infections. Health states included outpatient infections, inpatient hospitalizations, and RSV- and non-RSV-related deaths. RSV infection incidence rates were based on pre-COVID Centers of Disease Center (CDC) and claims database data. Efficacy data were based on clinical trials. A US payer perspective was used. Incremental cost-effectiveness ratio was calculated and presented as $/quality-adjusted life-year (QALY) gained. A series of sensitivity analyses, including probabilistic sensitivity analysis, were performed. The time horizon was one year. No discount rate was applied given the short time frame.

RESULTS: Compared to no intervention, Abrysvo and Beyfortus were cost-effective at a willingness-to-pay (WTP) threshold of 150,000 per QALY. The average cost per person was $173, $214, and $367 for no intervention, Abrysvo, and Beyfortus respectively. The average QALY per person for no intervention, Abrysvo, and Beyfortus was 0.970, 0.986, and 0.988. Abrysvo and Beyfortus had ICERs of $2,714/QALY and $11,089/QALY compared to no intervention. A one-way sensitivity analysis found that Abrysvo and Beyfortus remained cost-effective despite varying immunization efficacy, healthcare costs, and utility values. At a WTP threshold of $150,000/QALY, the probability that Beyfortus would be the most cost-effective was 80.3%.

CONCLUSIONS: When administered at the start of RSV season, Abrysvo and Beyfortus were found to be cost-effective compared to no intervention.