(124) Cost-Effectiveness of a Hypothetical Outpatient RSV Treatment for Elderly Patients in the United States

Background: : Respiratory syncytial virus (RSV) causes significant illness and healthcare burden, leading to an estimated 60,000 – 160,000 hospitalizations and 6,000 – 10,000 deaths annually among adults aged 65 years and older in the United States (US). Despite its impact, no treatment beyond supportive care is currently available. In light of ongoing pervasive vaccine hesitation and breakthrough infections, there is significant need for novel outpatient therapies that can be given shortly following positive diagnosis to prevent tracheobronchitis and pneumonia leading to hospitalization.

Objective: : To assess the cost-effectiveness of a hypothetical RSV treatment given in the outpatient or emergency department setting compared with current supportive care in elderly patients in the US.

Methods: : A decision tree model was developed examining the expected current healthcare utilization with recently approved RSV vaccines over a 1-year time horizon taking a societal perspective. The vaccinated and unvaccinated elderly population were simulated to seek care through outpatient, emergency department, or become hospitalized. Inputs for the model were gathered from published literature and governmental websites. The analysis varied the price, uptake, and effectiveness of hypothetical RSV treatment at reducing subsequent hospitalization after an outpatient or emergency department visit. The main outcome is an incremental cost-effectiveness ratio (ICER) with a $150,000 willingness-to-pay (WTP) threshold. Deterministic and probabilistic sensitivity analyses were explored.

Results: : In the base-case analysis, the ICER indicated that a hypothetical RSV treatment administered in outpatient or emergency department settings could be cost-effective. While the total direct costs were higher in the treatment group compared to the non-treated group, the treated group experienced significantly fewer quality-adjusted life years (QALYs) lost than those who did not receive treatment. The maximum allowable cost of the hypothetical RSV treatment fell within a reasonable per-patient amount. Further detailed results will be presented at the conference.

Conclusions: : Our model suggests that a hypothetical RSV treatment may be highly cost-effective compared to no treatment when given at the outpatient or emergency department setting to prevent disease progression. These findings support further development of RSV interventions for the elderly population in the US.

Sponsorship:: None