Cost-effectiveness analysis of bivalent respiratory syncytial virus prefusion F (RSVpreF) maternal vaccine for the prevention of RSV illness among infants in Hong Kong

OBJECTIVES: Respiratory syncytial virus (RSV) is a leading cause of hospital admissions for acute respiratory infection among infants. A novel RSV prefusion F protein subunit (RSVpreF) vaccine has been recently approved in Hong Kong. The clinical and economic burden of RSV among infants in Hong Kong, with and without a year-round RSVpreF maternal vaccination program, was evaluated. METHODS: A Markov model was used to estimate clinical and economic outcomes of RSV from birth to one year of age for maternal vaccination with RSVpreF compared to no intervention. Analyses were conducted from the healthcare system perspective, with direct costs (2025 United States dollars [US$]) and outcomes discounted at 3% annually; scenario and sensitivity analyses assessed the robustness of the model. RESULTS: Compared to no intervention, a year-round RSVpreF vaccination program with 20% uptake would prevent 113 hospitalizations and 256 outpatient encounters annually, averting US$300,000 in direct medical costs and saving 40 quality-adjusted life years (QALYs). The incremental cost-effectiveness ratio (ICER) was US$45,776/QALY gained, falling below the threshold of 1 x gross domestic product per capita (US$56,840). CONCLUSIONS: Year-round RSVpreF maternal vaccination would substantially reduce RSV's clinical and economic burden among infants in Hong Kong and would be a cost-effective program.