Cost-utility of Respiratory Syncytial Virus Prefusion F (RSVpreF) Maternal Vaccine for disease prevention among Colombian infants

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.