Background: Respiratory syncytial virus (RSV) is a common cause of acute respiratory infection (ARI). The risk of severe RSV outcomes is higher among older adults (OAs) and individuals with chronic diseases (high risk, HR). AS01_E-adjuvanted RSV preFusion protein 3 OA vaccine (adjuvanted RSVPreF3 OA is approved for the prevention of lower respiratory tract disease [LRTD] due to RSV in OAs). The objective of this study was to assess the potential public health impact of an RSV vaccination program using adjuvanted RSVPreF3 OA in adults ≥75 years (y) and HR adults ≥60 y in Italy. Methods: A static multi-cohort Markov model was used to estimate the number of RSV cases and associated health outcomes projected in adults ≥75 y and HR adults ≥60 y with no RSV vaccination or with a single dose of adjuvanted RSVPreF3 OA. Epidemiological, healthcare resource use and cost data were obtained from the scientific literature. Vaccine efficacy and waning inputs were based on results from the AReSVi-006 phase III clinical trial. Several scenarios for vaccine coverage were explored. Results: Assuming the target vaccination rate for influenza vaccination in Italy (75%), the model predicted that vaccinating Italian adults ≥75 y and the HR population ≥ 60 y with adjuvanted RSVPreF3 OA would reduce the number of RSV-LRTD events by 43%, leading to a reduction in associated emergency department visits, hospitalizations, complications, deaths, and direct healthcare costs over a 3-year period. Conclusions: The vaccination of Italians aged ≥ 75 y and HR individuals aged ≥ 60 y using the adjuvanted RSVPreF3 OA vaccine has the potential to offer substantial public health benefits by reducing the burden of RSV disease.

Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract disease in older adults. Vaccination is effective against RSV disease and can reduce disease and economic burden. A static, multicohort Markov model was adapted to the German setting to estimate the public health impact and cost-effectiveness of adjuvanted RSVPreF3 vaccination strategies from a societal perspective in three target populations: 1) at increased risk (AIR) adults aged 50-59 years and all adults ≥60 years, 2) all adults aged ≥60 years, and 3) AIR adults aged 60-74 years and all adults ≥75 years. A cycle length of 1 month and a 5-year time horizon were adopted. Vaccine coverage was 75% in the base case. RSV vaccination is cost-effective versus no vaccination (<€50,000 willingness-to-pay threshold): incremental cost-effectiveness ratios were €19,789, €19,631, and €12,733 for strategies 1, 2 and 3, respectively; 1.6, 1.4, and 0.8 million outpatient visits and 192,402, 185,238, and 152,781 hospitalizations could be prevented with strategies 1, 2, and 3, respectively. Expanding RSV vaccination to a larger target population would prevent more RSV cases, though at a higher cost per case averted; all vaccination strategies would be deemed cost-effective in Germany.

Background: Risk of herpes zoster (HZ) infection increases with age and immunosuppression. We estimated the impact of HZ and post-herpetic neuralgia (PHN) on direct costs and health care resource utilization (HCRU) in patients ≥50 years, including those with comorbidities, as limited information exists in Italy. Methods: This retrospective analysis used reimbursement data from local health authorities in Italy (January 2009–June 2022). Cases of HZ and PHN identified by International Classification of Diseases, Ninth Revision, Clinical Modification codes and drug prescriptions were characterized and followed up for 1 year before and after the index date. The direct HCRU costs for patients with HZ/PHN were compared with those for patients without HZ/PHN. Results: Of the total 193 259 patients with HZ/PHN identified (mean age, 61.6 years), 145 923 were ≥50 years old (immunocompromised: 29.9%; ≥1 chronic condition: 76.1%). During follow-up, 18.8% of patients ≥50 years of age with HZ progressed to PHN complications, and 3618 hospital admissions were reported (median length of stay, 9 days). Drug prescriptions and all-cause hospitalizations were the main contributors to total annual direct health care costs, estimated at M€272 for patients with HZ/PHN, whose burden increased with age. Higher health care costs were observed in patients with HZ/PHN vs patients without HZ/PHN. Moreover, average health care costs were up to 4× higher for patients with HZ and PHN compared with those without PHN. Conclusions: HZ causes a significant economic impact on the health care system, driven mainly by high costs of medications and hospitalizations among older adults and those with comorbidities, particularly when complicated by PHN.

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'). 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). 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. RSV vaccination may provide substantial health benefits and be a cost-effective intervention to reduce RSV burden in adults in Japan.

Chronic obstructive pulmonary disease (COPD) increases the risk of severe respiratory syncytial virus (RSV)-related disease. This analysis evaluated the potential public health impact and cost-effectiveness of RSV vaccination with a single dose of adjuvanted RSVPreF3 vaccine over five years in people aged 60-74 years with COPD in Italy. A static multi-cohort Markov model estimated RSV-related events, costs, and quality-adjusted life-years (QALY) over five years in people aged 60-74 years with COPD in Italy vaccinated with one dose of adjuvanted RSVPreF3, versus no vaccination. Vaccine efficacy and waning data were based on AReSVi-006 Phase III clinical trial results. Other input data came from published literature and official databases. Sensitivity analyses were conducted. A single dose of adjuvanted RSVPreF3 vaccine (75% coverage) was projected to reduce RSV-related acute respiratory infections by 29% and RSV-related hospitalizations and deaths by 38% among patients with COPD aged 60-74 years in Italy. The incremental cost-effectiveness ratio (health system perspective) was €1,306/QALY. These results indicated that a single dose of adjuvanted RSVPreF3 vaccine in patients with COPD aged 60-74 years in Italy is a cost-effective preventive option that could potentially reduce RSV-related disease burden and costs over five years.

Background Respiratory syncytial virus-associated acute respiratory illness (RSV-ARI) is an underrecognized cause of illness in older adults aged ≥ 75 years (OAs) and individuals at increased risk (AIR), contributing to a substantial disease burden. AS01E-adjuvanted RSV PreFusion protein 3 vaccine (aRSVPreF3) is approved for the prevention of RSV-associated lower respiratory tract disease (LRTD) in OAs. This study assesses the cost-effectiveness of a single dose of aRSVPreF3 vaccine among OAs and AIR individuals aged 60–74 years over 5 years in Italy. Methods A static multi-cohort Markov model with 5-year horizon and 1-month cycle length was developed to model the effect of aRSVPreF3 vaccination. Inputs were obtained from national databases and scientific literature. Sensitivity analyses were performed to assess the robustness of the results to variations in input parameters. Results At 75% coverage, aRSVPreF3 vaccination was predicted to prevent 1,253,641 and 1,083,247 RSV-ARI cases, and 552,517 and 579,008 RSV-LRTD cases, with direct healthcare costs reduced by €240,849,821 and €331,050,265 over a 5-year period in OAs and AIR individuals, respectively. Vaccination of OAs and AIR individuals was estimated to prevent 58,129 and 102,786 quality-adjusted life-year losses, yielding incremental cost-effectiveness ratios of €13,832 and €4,529, respectively. Conclusions Vaccination of OAs and AIR individuals with one dose of aRSVPreF3 has the potential to reduce RSV disease-associated burden and direct costs for the Italian National Healthcare System over a 5-year period. These results could support policymakers and clinicians in decision-making processes around the recommendation and implementation of RSV vaccination in Italy.