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Comparative Cost-Effectiveness Analysis of Respiratory Syncytial Virus Vaccines for Older Adults in Hong Kong.

ABSTRACT: Two respiratory syncytial virus (RSV) vaccines (AREXVY^® and ABRYSVO^®) were recently approved for older adults in the US. This study aimed to evaluate the cost-effectiveness of AREXVY^® and ABRYSVO^® from the Hong Kong public healthcare provider's perspective. A two-year decision-analytical model was developed to examine the outcomes of a single RSV vaccination (AREXVY^® or ABRYSVO^®) compared to no vaccination. Primary outcomes included RSV-related health outcomes, direct medical costs, quality-adjusted life-year (QALY) loss, and incremental cost per QALY (ICER). RSV vaccines are not yet marketed in Hong Kong, base-case analysis, therefore, benchmarked US RSV vaccine prices at 4 levels (25%, 50%, 75%, 100%). AREXVY^® and ABRYSVO^® (versus no vaccination) gained 0.000568 QALY and 0.000647 QALY, respectively. ICERs of ABRYSVO^® (26,209 USD/QALY) and AREXVY^® (47,485 USD/QALY) were lower than the willingness-to-pay threshold (49,594 USD/QALY) at 25% US vaccine price. The RSV attack rate was a common influential factor at all vaccine price levels. The probabilities of AREXVY^® and ABRYSVO^® to be most cost-effective were 0.10% and 97.68%, respectively, at 25% US vaccine price. Single vaccination of ABRYSVO^® or AREXVY^® for older adults appears to gain QALYs over 2 years in Hong Kong. The cost-effectiveness of AREXVY^® and ABRYSVO^® is subject to vaccine price and RSV attack rate.

SUBMITTER: Wang Y

PROVIDER: S-EPMC10610694 | biostudies-literature | 2023 Oct

REPOSITORIES: biostudies-literature

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Comparative Cost-Effectiveness Analysis of Respiratory Syncytial Virus Vaccines for Older Adults in Hong Kong.

Wang Yingcheng Y Fekadu Ginenus G You Joyce H S JHS

Vaccines 20231017 10

Two respiratory syncytial virus (RSV) vaccines (AREXVY® and ABRYSVO®) were recently approved for older adults in the US. This study aimed to evaluate the cost-effectiveness of AREXVY® and ABRYSVO® from the Hong Kong public healthcare provider's perspective. A two-year decision-analytical model was developed to examine the outcomes of a single RSV vaccination (AREXVY® or ABRYSVO®) compared to no vaccination. Primary outcomes includ ...[more]

PMID: 37897008

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Project description:BackgroundIn observational studies moderate alcohol use reduces cardio-respiratory mortality. However observational studies may be biased by many factors including residual confounding by unmeasured differences between moderate alcohol users and other groups or by changes in alcohol use with ill-health and aging. We used two different analytic strategies in an under-studied population, i.e. southern Chinese, to provide an assessment of the specific impact of moderate alcohol use on mortality from ischemic heart disease (IHD) and chronic obstructive pulmonary diseases (COPD).MethodsIn a population-based case-control study of all adult deaths in Hong Kong Chinese in 1998, we used adjusted logistic regression to compare alcohol use in decedents aged > or = 60 years from IHD (2270) and COPD (1441) with 10,320 living and 9043 dead controls (all non-alcohol related deaths). We also examined whether the association of alcohol use with death from IHD or COPD varied with sex or smoking status.ResultsUsing living controls and adjusted for age, socio-economic status and lifestyle, occasional and moderate alcohol use were generally associated with lower mortality from IHD and COPD. However, using dead controls the protection of occasional and moderate alcohol use appeared to be limited to ever-smokers for IHD (odds ratio (OR) 0.58, 95% confidence interval (CI) 0.46 to 0.73 for moderate compared to never-use in ever-smokers, but OR 1.07, 95% CI 0.76 to 1.50 in never-smokers), and possibly to men for COPD. High alcohol use was associated with lower IHD mortality and possibly with lower COPD mortality.ConclusionHigh levels of alcohol use in an older Chinese population were associated with lower IHD mortality. Moderate alcohol use was less consistently protective against IHD mortality. Alcohol use was associated with lower COPD mortality particularly in men, either due to some yet to be clarified properties of alcohol or as the artefactual result of genetic selection into alcohol use in a Chinese population. Given the increasing use of alcohol in China with economic development, other designs and analytic strategies are needed to assess the impact of alcohol in this population, so that an evidence-based public health policy can be formulated.

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Dataset Information

Comparative Cost-Effectiveness Analysis of Respiratory Syncytial Virus Vaccines for Older Adults in Hong Kong.

Publications

Comparative Cost-Effectiveness Analysis of Respiratory Syncytial Virus Vaccines for Older Adults in Hong Kong.

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