The use of RSV vaccination in pregnant women
RSV (respiratory syncytial virus) is a virus that causes cold-like symptoms and can lead to severe infections of the lower respiratory tract in infants, toddlers and older adults. The RSVpreF vaccine (Abrysvo®) is given to pregnant women between the 32nd and 36th weeks of pregnancy to provide passive protection to infants from birth to six months of age.
This report assesses the cost-benefit ratio and budget impact of maternal RSVpreF vaccination during pregnancy compared with nirsevimab or no RSV prevention.
The study conducted two systematic reviews of nirsevimab and RSVpreF, incorporating six clinical and ten economic studies. The clinical studies reported a good level of efficacy and safety for both drugs, but this could not be statistically confirmed. The economic studies excluding models from Switzerland reported that the RSVpreF vaccination had a better cost-benefit ratio than no RSV prevention, and that nirsevimab had a better cost-benefit ratio compared with no RSV prevention and compared with RSVpreF vaccination. The newly-developed model, adapted to Switzerland, showed that administering the RSVpreF vaccination would reduce costs by CHF 9.7 million a year compared with nirsevimab, with a loss of 18.2 quality-adjusted life years (QALY). This would result in additional savings per lost quality-adjusted life year (ICER) of CHF 538,075. Compared with no RSV prevention, RSVpreF increases costs by CHF 430,224 per year, but leads to a gain of 27.8 quality-adjusted life years. This results in additional costs per quality-adjusted life year gained of CHF 15,497. The analysis of the budget impact estimates that introducing the RSVpreF vaccination in newborns would reduce the total costs by CHF 14.8 million over five years.
The report concludes that nirsevimab and RSVpreF are effective and safe for the prevention of RSV infections in infants. Compared with nirsevimab, RSVpreF should have a more favourable cost-benefit ratio as the loss of quality-adjusted life years is offset by the cost saving. While RSVpreF vaccination would increase health expenditure compared with no RSV prevention, it would also result in a gain in quality-adjusted life years. This indicates that introducing RSVpreF vaccination for RSV prevention will reduce total health spending.
Further information
Federal Office of Public Health FOPH
Health Technology Assessment Section
Schwarzenburgstrasse 157
Switzerland - 3003 Bern