Cost-effectiveness of the adjuvanted respiratory syncytial virus prefusion F protein (RSVPreF3) vaccine in Japanese adults aged 50–59 years at increased risk of severe RSV disease and those aged ≥60 years

BACKGROUND: Respiratory syncytial virus (RSV) can cause substantial morbidity and mortality in adults aged 50-59 years at increased risk of severe RSV disease due to specific underlying conditions (i.e. '50-59 years at-increased-risk [AIR] population'), and in older adults aged ≥60 years (i.e. '≥60 years population'). RESEARCH DESIGN AND METHODS: A static multi-cohort Markov model estimated cost-effectiveness of adjuvanted RSVPreF3 vaccination versus no vaccination among the 50-59 years AIR and ≥60 years populations in Japan, over a five-year time horizon from a healthcare payer perspective. Japan-specific RSV epidemiology and healthcare resource utilization parameters were used; vaccine efficacy was derived from the phase 3 AReSVi-006 trial (NCT04886596). RESULTS: Adjuvanted RSVPreF3 vaccination was cost-effective: in the 50-59 years AIR population, 49,280 RSV cases were prevented and 4333 quality-adjusted life years (QALYs) gained, at an incremental cost-effectiveness ratio (ICER) of Japanese yen (JPY) 2,770,558/QALY; in the ≥60 years population, 2,111,080 RSV cases were prevented and 205,543 QALYs gained, at an ICER of JPY 2,613,241/QALY. Vaccination was more cost-effective when including productivity losses from RSV-ARI. Scenario and sensitivity analyses results were robust. CONCLUSIONS: RSV vaccination may provide substantial health benefits and be a cost-effective intervention to reduce RSV burden in adults in Japan.