1045-P: Cost-Effectiveness of Adjuvanted RSVPreF3 Vaccination in Adults Aged 50–59 Years with Diabetes in the United States

• Published in: Diabetes (New York, N.Y.) Vol. 73; p. 1
• Main Authors: Singer, David, La, Elizabeth, Graham, Jonathan, Grace, Mei, Poston, Sara, Molnar, Daniel
• Format: Journal Article
• Language: English
• Published: New York American Diabetes Association 01-06-2024
• Subjects: Comorbidity; Cost analysis; Diabetes; Diabetes mellitus; Immunization; Markov chains; Metabolic disorders; Respiratory diseases; Respiratory syncytial virus; Respiratory tract diseases; Vaccination; United States > US
• ISSN: 0012-1797; 1939-327X
• DOI: 10.2337/db24-1045-P

Introduction & Objective: Older adults and adults with comorbidities, such as metabolic diseases, are at increased risk of severe respiratory syncytial virus (RSV) disease. This study assessed the cost-effectiveness of adjuvanted RSVPreF3 vaccination in adults 50-59 years of age (YOA) with diabetes in the US. Methods: A Markov model was used to estimate costs and health outcomes over a 3-year time horizon from a societal perspective, comparing scenarios with and without one-time adjuvanted RSVPreF3 vaccination. Indirect costs and quality-adjusted life year (QALY) losses due to RSV-related death were modeled over the remaining lifetime. The population included 5,617,227 US adults 50-59 YOA with diabetes. Vaccination coverage of 50.1% was assumed, based on influenza vaccination coverage. Scientific literature and public sources were used to inform model inputs. Incremental cost and health outcomes were reported along with the incremental cost-effectiveness ratio (ICER), comparing adjuvanted RSVPreF3 vaccination to no vaccination. Results: Over the 3-year time horizon, adjuvanted RSVPreF3 vaccination avoided an estimated 180,546 symptomatic RSV acute respiratory illnesses, including 144,676 lower respiratory tract disease cases, 108,392 RSV-related outpatient visits, and 7,841 RSV-related hospitalizations. Vaccination resulted in incremental total societal costs of -$39 million (M), including incremental direct and indirect costs of $623M and -$662M, respectively. Adjuvanted RSVPreF3 vaccination avoided 10,290 QALY losses and 551 RSV-related deaths. With improved health outcomes and lower societal costs, adjuvanted RSVPreF3 vaccination was dominant versus no vaccination (ICER <$0 per QALY gained). Conclusion: One-time adjuvanted RSVPreF3 vaccination resulted in improved health outcomes and reduced societal costs compared to no vaccination, suggesting it is cost-effective for the prevention of RSV in adults 50-59 YOA with diabetes.