Cost-utility of respiratory syncytial virus prefusion F (RSVpreF) maternal vaccine for disease prevention among colombian infants

<title>Abstract</title> Background Respiratory Syncytial Virus (RSV) is one of the leading causes of acute lower respiratory tract infections in Colombia, therefore, as no widespread antiviral exists, maternal immunization using RSV prefusion F protein vaccine (RSVpreF) represents a promising strategy. This study aims to evaluate the cost-utility of the RSVpreF maternal vaccine in preventing RSV infections among Colombian infants. Methods We used a Markov model to simulate a Colombian birth cohort over a lifetime horizon, comparing maternal RSVpreF vaccination with no intervention. The model incorporated RSV-related outpatient visits, hospitalizations, and deaths. We collected data from clinical trials, peer-reviewed literature, and Colombian national health databases. Costs were analyzed from the perspective of the Colombian healthcare system, adjusted to 2024 USD, and we applied a 5% discount rate to both costs and outcomes. We used a willingness-to-pay (WTP) threshold of $ 7,491 per quality-adjusted life year (QALY). Sensitivity analyses, including one-way and probabilistic sensitivity analyses, were performed to evaluate the robustness of the results. Results Maternal RSVpreF vaccination was associated with a reduction of approximately 25,781 RSV-related cases and an increase of 2,315 QALYs. The incremental cost-effectiveness ratio (ICER) was $ 2,322 per QALY, well below the WTP threshold. Sensitivity analyses identified vaccine effectiveness and RSV hospitalization rates as the primary drivers of cost-effectiveness. The probabilistic sensitivity analysis showed an 87.8% probability of the intervention being cost-effective at the established WTP threshold. Conclusion Maternal RSVpreF vaccination is a cost-effective intervention in Colombia, leading to significant reductions in RSV-related morbidity, mortality, and economic burden on the healthcare system. The findings support the inclusion of maternal RSV vaccination in national immunization programs, promoting health equity in underserved communities.