Introduction

Research unveiled in the journal *Vaccine* suggests that vaccinating adults aged 60 and older against respiratory syncytial virus (RSV) may be a financially savvy approach to minimize illness, hospitalizations, deaths, and even loss of quality of life.

The Threat of RSV to Older Adults

The threat posed by RSV to older adults is alarming. This virus is not only associated with serious health complications, but the incidence of hospitalizations and severe outcomes has been found to escalate with age. Shockingly, health care costs linked to RSV for this demographic are projected to soar to a staggering $6.6 billion annually.

FDA Approval and Recommendations

In a significant stride for public health, the FDA approved GSK’s Arexvy and Pfizer’s Abrysvo vaccines for RSV in May 2023. Historically, the focus on RSV prevention has primarily fixated on younger individuals, leaving older adults at risk. However, the Advisory Committee on Immunization Practices recognized the dire need for protection in the older population and recommended a single dose of the RSV vaccine for adults aged 60 and above in June 2023.

Study Overview

A comprehensive study was conducted by University of Michigan researchers in collaboration with the CDC, targeting the more than 75 million adults in the U.S. aged 60 and older. Researchers delved into RSV-related health care usage, covering outpatient visits, emergency room reports, hospital stays, and mortality rates to understand the potential impact of vaccination.

Study Objectives

The primary goal was to quantify the potential RSV illness prevention from vaccination (assuming a two-season effectiveness) and to assess the cost-effectiveness of both vaccines compared to older adults who do not receive the vaccination. Their analysis also examined the cost-effectiveness across various age subgroups, determining how many vaccinations would be necessary to prevent specific health outcomes.

Methodology

To achieve this analysis, investigators created a decision-analytical model that simulated the effects of a single-dose RSV vaccine for older adults. The model meticulously assessed the long-term implications of vaccination, considering quality-adjusted life-years (QALYs) lost and societal costs from RSV-related fatalities. Utilizing wholesale costs of $280 for GSK’s and $295 for Pfizer’s doses, they painted a comprehensive picture of the economic impact.

Key Findings

The findings were revealing: achieving a 20% vaccination rate among adults aged 65 and older with either vaccine could reduce outpatient RSV illnesses by a notable 10.2% to 11.1%, as well as decrease hospitalizations and in-hospital mortality by 13.5% to 14.7%. However, the research indicated that a more substantial vaccination coverage would yield even more favorable outcomes.

Economic Implications

While the vaccination proved to reduce certain healthcare costs, it also led to an increase in lifetime societal costs across all age groups due to the price of the vaccines. Specifically, vaccinating 20% of adults aged 65 and older resulted in an additional cost between $3.4 and $3.6 billion for the vaccines. This figure, however, was partially offset by savings from reduced healthcare costs ($460 to $500 million) and productivity impacts ($400 to $450 million), resulting in a net additional cost of $2.5 to $2.6 billion.

Cost-Effectiveness Analysis

The societal cost per QALY saved varied by age and vaccine. For instance, administering GSK's vaccine to adults aged 60 and older would cost $196,842 per QALY saved, while Pfizer's would be $176,557. For those aged 65 and older, costs dropped further to $162,138 for GSK and $146,543 for Pfizer. Higher costs per QALY were observed for younger subgroups.

Benefits of Vaccination

Despite some adverse events associated with vaccination, the overall benefits were significant, with estimates indicating the potential to save approximately 15,700 to 18,000 QALYs among vaccinated adults aged 65 and older compared to non-vaccinated individuals.

Conclusion and Future Research

David Hutton, a prominent author of the study and a professor of health management and policy at the University of Michigan, underscored the importance of the research. 'We view this as a pivotal study that highlights the potential of RSV vaccination to make significant public health and economic impacts for older adults,' he stated. Going forward, the researchers believe that enhancing the cost-effectiveness of RSV vaccination can be achieved through lower vaccine prices and longer-lasting immunity. They emphasized the critical need for further research to explore the long-term safety and effectiveness of the vaccine across diverse age brackets, including those younger than 60.

Implications for Healthcare Policy

As RSV continues to be a formidable threat to older adults, the findings from this study present a timely opportunity for health policymakers to rethink strategies for respiratory disease prevention. **What could this mean for the future of healthcare for older adults? Stay tuned to find out!**