The use of RSV vaccination in older adults
RSV (respiratory syncytial virus) is a seasonal virus that causes cold-like symptoms and in older adults can lead to infections of the respiratory tract involving hospitalisation or even death. In Switzerland, the authorised vaccines are RSVpreF (Abrysvo®), mRNA-1345 (mRESVIA®) and RSVPreF3 (Arexvy®).
This analysis provides information for a possible cost reimbursement of the three vaccines, compares the cost-benefit ratio and highlights the potential impact on the compulsory health insurance budget. The vaccinations are compared over a time frame of two years compared with no prevention for both target groups (those aged 75 or over, and those aged between 60 and 75 with a high risk of complications).
A systematic literature review incorporated three clinical studies for the three vaccines, and three economic analyses. The studies showed that during an RSV season, the vaccines exhibited efficacy of between 82.4% and 85.7% against diseases of the lower respiratory tract in persons aged 60 or over compared with a placebo. Two economic analyses from other countries reported that the maximum price per dose of RSVPreF3 and RSVpreF vaccine should be around USD 120 for the cost-benefit ratio to be positive. A third study from a Chinese health perspective resulted in an unfavourable cost-benefit ratio. The newly-developed model for Switzerland showed that in both groups, administering RSV vaccines every two years would lead to a gain in quality-adjusted life years and higher costs compared with no prevention. For those aged 75 or over, the additional costs per quality-adjusted life year (QALY) gained were approximately CHF 244,000 for RSVPreF3, CHF 292,000 for RSVpreF and CHF 259,000 for mRNA-1345. Meanwhile, in those aged between 60 and 75 with a high risk of complications, the additional costs per quality-adjusted life year gained (ICER) were around CHF 281,000, CHF 334,000 and CHF 297,000 respectively. In the analysis, the budget impact of reimbursement of the three RSV vaccines over a two-year period was CHF 80.58 million for RSVPreF3, CHF 81.58 million for RSVpreF, and CHF 80.91 for mRNA-1345 in the 75+ group, and CHF 12.83 million, CHF 13.0 million and CHF 12.89 million respectively in the group aged between 60 and 75 with a high risk of complications.
The report concludes that the three vaccines are effective for a single dose and for one RSV season. The economic analysis showed that a vaccination to prevent RSV resulted in additional quality-adjusted life years and extra costs compared with no prevention. Both in terms of the cost-benefit ratio and in terms of the budget impact, the vaccine price is the main driver of the higher costs.
Further information
Federal Office of Public Health FOPH
Health Technology Assessment Section
Schwarzenburgstrasse 157
Switzerland - 3003 Bern