Economics of Vaccinating U.S. Adults ≥60 

years-old against 

Respiratory Syncytial Virus

UPDATED SUMMARY COMPARING MODELS FROM:

GSK, Pfizer AND University of Michigan-CDC

Ismael R. Ortega-Sanchez, PhD

NCIRD/CDC

ACIP Meeting, June 21, 2023

1

Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the views of 

the Centers for Disease Control and Prevention. 

National Center for Immunization & Respiratory Diseases
Conflict of interest

• GSK model: Daniel Molnar et al., [complete list and affiliations, upon request]

• GSK manufactures the adjuvanted RSVPreF3 vaccine 

• RTI Health Solutions was funded by GSK

• Pfizer model: Derek Weycker et al., [complete list and affiliations, upon request]

• Pfizer manufacturers the bivalent RSVpreF vaccine

• Policy Analysis Inc. was funded by Pfizer

• UM-CDC model: David W Hutton et al. from Univ Michigan, ..., Ismael R OrtegaSanchez et al. from CDC [complete list and affiliations, upon request ]

• All authors: No conflicts of interest

2
Economic analysis

Policy questions: Should adults ≥65 years of age (or ≥60 years of age) receive 

one dose of Respiratory Syncytial Virus (RSV) vaccine (GSK or Pfizer product) for 

the prevention of RSV disease and its complications?

Question: Is vaccinating adults aged ≥65 years (or ≥60 years) against RSV costeffective?

Comparator Intervention

Base-case scenario: What is the incremental cost-effectiveness of vaccinating adults aged 

≥65 years (or ≥60 years) using RSV vaccine relative to “No vaccination”?

3

Unvaccinated 

≥65yr-olds

(or ≥60yr-olds)

Vaccinating

≥65yr-olds

(or ≥60yr-olds)
Focus on key features for model comparison

• Modeling approach

• Targeted population(s)

• Perspective (healthcare vs. societal)

• Intervention strategy and comparator

• Inputs for RSV disease burden, vaccine efficacy, and costs

• Incidence of RSV disease, rates of outcomes

• Direct and indirect costs of RSV disease

• Intervention: Vaccine efficacy, duration of protection, safety and program 

costs

• Assumptions

• Strong, influential assumptions

4

Note: For this and all slides, to specifically identify changes and updates from those presented last February 2023, the text will 

appear either highlighted, marked in red or with the word updated at the top of the slide or table.
5

Modeling design and assumptions

GSK Pfizer UM-CDC

Static analytical decision-making models ✔ ✔ ✔

Sensitivity analyses (and probabilistic simulation) ✔(✔) ✔(✔) ✔

Hypothetical population ≥65yrs-old (and ≥60-yrs-old) ✔(✔) ✔(✔) ✔(✔)

Time Frame: at least 2 yr. after a dose of RSV vaccine ✔ ✔ ✔

Analytic Horizon: Age-specific Life Expectancy ✔ ✔ ✔

Discount rate: 3% ✔ ✔ ✔

Year of economic outcomes measured: 2022 ✔ ✔ ✔

Societal perspective (and healthcare perspective) ✔(✔) ✔(✔) ✔(✔)
6

Inputs and main outcomes

Prevention of:

• Outpatient visits for RSV

• RSV hospitalizations

• RSV-associated deaths

QALYs saved

$/QALY saved

Number needed to

vaccinate (NNV) to avert an: 

• Outpatient visit for RSV

• RSV hospitalization

• RSV-associated death

GSK

Updated

Pfizer

Updated

UM-CDC

Updated

✔ ✔ ✔

✔ ✔ ✔

✔ ✔ ✔

✔ ✔ ✔

✔ ✔ ✔

✔ ✔ ✔

✔ ✔ ✔

✔ ✔ ✔

HCRU = health care resource use
GSK, Pfizer and UM-CDC models comparison: 

Selected outcome ratios for RSV vaccines (Feb 2023)

7

UM-CDC 

model

Vac Price 

$100

GSK 

model

Vac Price 

$148

$ / QALY gained

Vaccinating adults ≥65 yrs. 180,720 68,489

Vaccinating adults ≥60 yrs. 229,895 78,971

$ / hospitalization averted

Vaccinating adults ≥65 yrs. 101,406 57,114

Vaccinating adults ≥60 yrs. 133,992 69,638

GSK vaccine

UM-CDC 

model

Vac Price 

$100

Pfizer

model

Vac Price 

$200

$ / QALY gained

Vaccinating adults ≥65 yrs. 189,407 43,749

Vaccinating adults ≥60 yrs. 233,779 50,197

$ / hospitalization averted

Vaccinating adults ≥65 yrs. 122,886 19,845

Vaccinating adults ≥60 yrs. 161,310 23,271

Pfizer vaccine
GSK, Pfizer and UM-CDC models comparison: 

Selected outcome ratios for RSV vaccines (June 2023)

8

UM-CDC 

model

Vac Price 

$270

GSK 

model

Vac Price

$270

$ / QALY gained

Vaccinating adults ≥65 yrs. 167,301 55,088

Vaccinating adults ≥60 yrs. 205,638 64,348

$ / hospitalization averted

Vaccinating adults ≥65 yrs. 94,375 43,456

Vaccinating adults ≥60 yrs. 120,056 53,644

GSK vaccine

UM-CDC 

model

Vac Price 

$200

Pfizer

model

Vac Price 

$200

$ / QALY gained

Vaccinating adults ≥65 yrs. 94,673 19,585

Vaccinating adults ≥60 yrs. 118,735 23,921

$ / hospitalization averted

Vaccinating adults ≥65 yrs. 56,571 8,797

Vaccinating adults ≥60 yrs. 75,382 10,982

Pfizer vaccine
$50 $100 $150 $200

Vaccine Cost

VE against hospitalization and ED S2

Incidence of RSV hospitalization

VE against hospitalization and ED S1

Cost per Hospitalization

Outpatient QALYs Lost, Adult

Incidence of outpatient visits for RSV

Mortality, adults hospitalized with RSV

VE against oupatient illness S2

ED Incidence

Low Assumption High Assumption

$50 $100 $150 $200 $250 $300

Incidence of RSV hospitalization

VE against hospitalization and ED S2

Vaccine Cost

Outpatient QALYs Lost, Adult

Cost per Hospitalization

VE against hospitalization and ED S1

Incidence of outpatient visits for RSV

Mortality, adults hospitalized with RSV

VE against oupatient illness S2

ED Incidence

GSK: $/QALY gained (thousands)

Low Assumption High Assumption

UM-CDC model: Updated One-way Sensitivity Analyses

Base case: Age ≥65yrs; $167,301/QALY (GSK), $94,673/QALY (Pfizer)

9

Vaccine cost per dose $270/dose (GSK), $200/dose (Pfizer)

Two-year time frame

Age-based vaccination recommendation: ≥65 years, VE=Vaccine Efficacy LRTD= Lower Respiratory Tract Disease, S1=Season 1, S2=Season 2.
GSK model: Updated One-way Sensitivity Analyses

Base case: Age ≥60 years; $ 64,348 /QALY saved*

10 * GSK base-case vaccine price = $270/dose, three-year time frame

Average annual incidence of first RSV ARI event

Percentage of RSV LRTD cases resulting in hospitalization

Efficacy against RSV LRTD: Waning rates first vaccination with RSVPreF3 vaccine <36 months

RSVPreF3 vaccine: Peak % efficacy after first vaccination against RSV LRTD caused by first RSV infection

Probability of death given RSV LRTD

Vaccination costs per administered dose with RSVPreF3 vaccine - Purchase cost per dose – Cost

Proportion RSV LRTD within first RSV ARI event

Baseline QALYs - General population

Efficacy against RSV ARI: Waning rates first vaccination with RSVPreF3 vaccine <36 months

RSVPreF3 vaccine: Peak % efficacy after first vaccination against first RSV ARI event

Direct cost per RSV LRTD event @ 1st infection - Unvaccinated
Pfizer model: Updated One-way Sensitivity Analyses

Base case: Age≥60 years: $23,921/QALY saved*

11

Base case

* Pfizer base-case vaccine price = $200/dose, RSV-H= RSV-associated hospitalization
GSK, Pfizer and UM-CDC models comparison: 

Selected inputs 

12

• RSV-hospitalization rate

GSK: Proportion of medically attended RSV hospitalized cases identified by PCR, differentiated by age 

(Belongia, 2018)

Pfizer: Differentiated by age and comorbidity profile (Pfizer data on file)

CDC: Differentiated by age (four RSV seasons in CDC RSV-NET data)

• Initial VE & waning over time: (updated data from GSK’s & Pfizer’s phase 3)

GSK: VE peaks in month 2, wanes linearly, reaching 0% at 34 or 43mos (depending on outcome)

Pfizer: VE is flat 7mos, wanes linearly thereafter, reaches 0% at 24mos

CDC: Step-wise: VE flat 7mos, partial drop & flat 7-14mos (Pfizer), 7-18mos (GSK), reaches 0% at 24mos

• Unitary medical cost of RSV outcomes

GSK: Age- & outcome specific cost for symptomatic RSV LRTD & URTI cases (medically attended and 

non-medically attended) (data from Centers for Medicare and Medicaid Services)

Pfizer: Age-, outcome- & comorbidity-specific cost for medically attended RSV illness

CDC: Age- & outcome-specific cost for medically attended RSV illness

ARI = acute respiratory infection

LRTD = lower respiratory tract disease

URTI = upper respiratory tract illness 
13

UM-CDC GSK Pfizer

Incidence of RSV outpatient illness 

(per 100,000 persons per year)

2,278

(base-case for adults ≥65 years)a

1,348

(for adults ≥65 years)b

2,430

(base case for adults 

≥65 years)c

Incidence of RSV hospitalization 

(per 100,000 persons per year)

162

(base-case for adults ≥65 years)d

256.3

(for adults ≥65 years)b,e

300

(base-case for adults 

≥65 years)c

Direct medical costs per RSV 

hospitalization $21,417 – $22,425

(age-dependent)f

$13,112 – $26,224

(age-dependent)g,h

$12,048 – $38,380

(age- and comorbiditydependent)h,i

a McLaughlin et al. Open Forum Infect Dis (2022): https://doi.org/10.1093/ofid/ofac300

b Adapted from Belongia et al. Open Forum Infect Dis (2018): https://doi.org/10.1093/ofid/ofy316

c Adapted from McLaughlin et al. Open Forum Infect Dis (2022): https://doi.org/10.1093/ofid/ofac300; Ramirez et al. Infect Dis Ther (2023): https://doi.org/10.1007/s40121-023-00805-1

d RSV-NET, CDC unpublished data. Age-specific hospitalization rate per 100,000: 65.5 (60 to <65yrs), 93.8 (65 to <70yrs), 118.7 (70 to <75yrs) and 302.9 (75+yrs). Crude surveillance rates were 

upwardly adjusted 1.5x due to incomplete case detection from reliance on upper respiratory RT-PCR (McLaughlin et al. Open Forum Infect Dis (2022): https://doi.org/10.1093/ofid/ofac300

e Adapted from Falsey et al. NEJM (2005): https://doi.org/10.1056/nejmoa043951; Herring et al. Vaccine (2022): https://doi.org/10.1016/j.vaccine.2021.12.002

f Ackerson et al. J Infect Dis (2020). Updated to Q3 2022$ using GDP Deflator: https://doi.org/10.1093/infdis/jiaa183; Branche et al. Clin Infect Dis (2022): https://doi.org/10.1093/cid/ciab595

g CMS Medicare Inpatient Hospitals (DRG Average Payments from 2019 dataset)

h Kaiser Family Foundation (How much more than Medicare do private insurers pay? 2020): https://www.kff.org/medicare/issue-brief/how-much-more-than-medicare-do-private-insurerspay-a-review-of-the-literature/

i Merative MarketScan Commercial Claims and Encounters (CCAE) and Medicare Supplemental Coordination of Benefits (MDCR) Databases (2016-2019)

GSK, Pfizer and UM-CDC models: Key differences in 

model inputs 
UM-CDC model: Sensitivity of Cost per QALY saved to RSV-Related 

Hospitalization Rates among Adults ≥65 years: 2-year timeframe

14

Base case for Pfizer and GSK are shown with blue and orange solid filled diamond markers, respectively: Estimated using the adjusted mean RSV-related hospitalization rate over RSV seasons: 2015-16, 

2016-17, 2017-18, and 2018-19. Adjusted rate for lower sensitivity of PCR testing. CDC RSVnet

Blue ball markers: Estimated using Pfizer vaccine VE and price input data for the specific hospitalization rate as reported by the reference. 

Orange ball markers: Estimated using GSK vaccine VE and price input data for the specific hospitalization rate as reported by the reference.

Labels in markers: They refer to the specific source of the RSV-associated hospitalization rate used in the estimation of either vaccine cost per QALY saved. Parentheses include either the year of the 

publication or the place where the data for the study was collected. 

Pfizer Base

Pfizer Branche (Rochester)

Pfizer Branche (NYC)

Pfizer Belongia

Pfizer Widmer (2012)

Pfizer Widmer (2014)

GSK Base

GSK Branche (Rochester)

GSK Branche (NYC)

GSK Belongia

GSK Widmer (2012)

GSK Widmer (2014)

 $-

 $40,000

 $80,000

 $120,000

 $160,000

 $200,000

 $240,000

 - 50 100 150 200 250 300

Incremental cost per QALY gained

RSV-related hospitalization rate per 100,000
UM-CDC model: Sensitivity of Cost per QALY saved to RSV-Related 

Hospitalization Rates among Adults ≥65 years: 2-year timeframe

15

Pfizer Base

Pfizer Branche (Rochester)

Pfizer Branche (NYC)

Pfizer Belongia

Pfizer Widmer (2012)

Pfizer Widmer (2014)

GSK Base

GSK Branche (Rochester)

GSK Branche (NYC)

GSK Belongia

GSK Widmer (2012)

GSK Widmer (2014)

 $-

 $40,000

 $80,000

 $120,000

 $160,000

 $200,000

 $240,000

 - 50 100 150 200 250 300

Incremental cost per QALY gained

RSV-related hospitalization rate per 100,000

Base case for Pfizer and GSK are shown with blue and orange solid filled diamond markers, respectively: Estimated using the adjusted mean RSV-related hospitalization rate over RSV seasons: 2015-16, 

2016-17, 2017-18, and 2018-19. Adjusted rate for lower sensitivity of PCR testing. CDC RSVnet

Blue ball markers: Estimated using Pfizer vaccine VE and price input data for the specific hospitalization rate as reported by the reference. 

Orange ball markers: Estimated using GSK vaccine VE and price input data for the specific hospitalization rate as reported by the reference.

Labels in markers: They refer to the specific source of the RSV-associated hospitalization rate used in the estimation of either vaccine cost per QALY saved. Parentheses include either the year of the 

publication or the place where the data for the study was collected. 
UM-CDC model: Sensitivity of Cost per QALY saved to RSV-Related 

Hospitalization Rates among Adults ≥65 years: 2-year timeframe

16

Pfizer Base

Pfizer Branche (Rochester)

Pfizer Branche (NYC)

Pfizer Belongia

Pfizer Widmer (2012)

Pfizer Widmer (2014)

GSK Base

GSK Branche (Rochester)

GSK Branche (NYC)

GSK Belongia

GSK Widmer (2012)

GSK Widmer (2014)

 $-

 $40,000

 $80,000

 $120,000

 $160,000

 $200,000

 $240,000

 - 50 100 150 200 250 300

Incremental cost per QALY gained

RSV-related hospitalization rate per 100,000

$55.1K, GSK (3-yr TF)

$19.6K, Pfizer

Base case for Pfizer and GSK are shown with blue and orange solid filled diamond markers, respectively: Estimated using the adjusted mean RSV-related hospitalization rate over RSV seasons: 2015-16, 

2016-17, 2017-18, and 2018-19. Adjusted rate for lower sensitivity of PCR testing. CDC RSVnet

Blue ball markers: Estimated using Pfizer vaccine VE and price input data for the specific hospitalization rate as reported by the reference. 

Orange ball markers: Estimated using GSK vaccine VE and price input data for the specific hospitalization rate as reported by the reference.

Labels in markers: They refer to the specific source of the RSV-associated hospitalization rate used in the estimation of either vaccine cost per QALY saved. Parentheses include either the year of the 

publication or the place where the data for the study was collected. 
UM-CDC model: Sensitivity of Cost per QALY saved to RSV-Related 

Hospitalization Rates among Adults ≥65 years: 2-year timeframe

17

Pfizer Base

Pfizer Branche (Rochester)

Pfizer Branche (NYC)

Pfizer Belongia

Pfizer Widmer (2012)

Pfizer Widmer (2014)

GSK Base

GSK Branche (Rochester)

GSK Branche (NYC)

GSK Belongia

GSK Widmer (2012)

GSK Widmer (2014)

 $-

 $40,000

 $80,000

 $120,000

 $160,000

 $200,000

 $240,000

 - 50 100 150 200 250 300

Incremental cost per QALY gained

RSV-related hospitalization rate per 100,000

$70.1K, GSK (2-yr TF)

$19.6K, Pfizer

Base case for Pfizer and GSK are shown with blue and orange solid filled diamond markers, respectively: Estimated using the adjusted mean RSV-related hospitalization rate over RSV seasons: 2015-16, 

2016-17, 2017-18, and 2018-19. Adjusted rate for lower sensitivity of PCR testing. CDC RSVnet

Blue ball markers: Estimated using Pfizer vaccine VE and price input data for the specific hospitalization rate as reported by the reference. 

Orange ball markers: Estimated using GSK vaccine VE and price input data for the specific hospitalization rate as reported by the reference.

Labels in markers: They refer to the specific source of the RSV-associated hospitalization rate used in the estimation of either vaccine cost per QALY saved. Parentheses include either the year of the 

publication or the place where the data for the study was collected. 
GSK, Pfizer and UM-CDC: Initial or Early Peak of 

Vaccine Efficacy & Decline in Season 2 (updated)

18

a VE over median (GSK) or mean (Pfizer) 7 months for season 1, VE through a median 18 months (GSK) or 14 months (Pfizer) for season 2 as reported in the follow up in phase 3 clinical trials

b Manufacturer phase 3 trial data; VE against medically attended acute respiratory illness

c GSK phase 3 trial data; VE against acute respiratory illness, regardless of whether medically attended. Reported peak value at month 2.

d GSK phase 3 trial data; VE against medically attended lower respiratory tract disease

e Pfizer phase 3 trial data; VE against medically attended lower respiratory tract illness with ≥3 lower respiratory symptoms

f GSK phase 3 trial data; VE against lower respiratory tract disease, regardless of whether medically attended. Reported peak value at month 2.

UM-CDC Model GSK Model Pfizer Model

GSK vaccine Pfizer vaccine GSK vaccine Pfizer vaccine

Vaccine efficacy (VE) against RSV 

outpatient illnessa Season 1

79.0

(54.3–91.5)b

65.2

(36.0–82.0)b

Season 1 Peak: 74.2

(56.4–94.0)

Weighted linear regression 

over time of estimated 

efficacy from clinical trialc

65.1

(35.9–82.0)b

Season 2

27.8

(0 – 60.4)b

55.0

(0 – 82.0)b

55.0

(95% CI: -3.4–82.0)b

VE against RSV hospitalization and 

emergency department visita Season 1

87.5

(58.9–97.6)

d

84.6

(32.0–98.3)e

Season 1 Peak: 88.0

(65.8–99.2)

Weighted linear regression 

over time of estimated 

efficacy from clinical trialf

84.6

(32.0–98.3)e

Season 2 52.9

(0 – 81.2)d

75.0

(0 – 97.4)e

75.0

(95% CI: -25.3–97.4)e
GSK, Pfizer and UM-CDC: Assumption on waning of 

vaccine efficacy (VE) per outcome (Feb 2023)

19

GSK

VE peaks at 2 months then wanes per month 

RSV-ARI = 5.36% points per month (range: 0.00-

13.37%) 

RSV-LRTD = 2.63% points per month (range: 0.00-

10.95%)

No residual protection after 12 months

Pfizer

Initial VE assumed to persist for 7 months, 

Then to decline linearly to 0% effectiveness at 24 

months

Residual though declining protection up to 24 

months

UM

-CDC

Vaccine and outcome-specific

For both vaccines:

Exponential decay up to 12 months 

and then 0% afterwards; calibrated such that the 

first 6 months VE equals the trial estimate
GSK, Pfizer and UM-CDC: Assumption on waning of 

vaccine efficacy (VE) per vaccine & outcome (June 2023)

20

GSK

UM-CDC UM-CDC

The pink-shaded areas denote a higher level of uncertainty of the waning assumption beyond available phase 3 data
Feb 2023

GSK: Residual Vaccine Effectiveness (Feb 2023 

ACIP) and updated analyses (June 2023)

21

RSV LRTD: 50% of peak VE (88%) 

assumed in month 1, peak VE 

declines by 2.10% (2.63% in Feb) 

monthly rate beginning in month 2 

though 20-month maximum follow 

up of trial. Assumed to follow 

linear decline trend afterwards. 

Reaches 0% in month 43 

RSV ARI: 50% of peak VE (74%) 

assumed in month 1, peak VE 

declines by 2.26% (5.36% in Feb) 

monthly rate beginning in month 2 

though 20-month maximum follow 

up of trial. Assumed to follow 

linear decline trend afterwards. 

Reaches 0% in month 34 

The pink-shaded area denotes a higher level of uncertainty of the waning assumption beyond 

available phase 3 data
Pfizer: Residual Vaccine Effectiveness (Feb 

2023 ACIP) and updated analyses (June 2023)

22

Hospitalization or ED: Initial 

VE (84.6%) assumed to 

persist for 7 months, to 

decline to 75% at 14 months, 

and then decline to 0% at 

24th month 

Outpatient: Initial VE (65.1%) 

assumed to persist for 7 

months, to decline to 55% at 

14 months, and then decline 

to 0% at 24th month 

The pink-shaded area denotes a higher level of uncertainty of the waning assumption beyond 

available phase 3 data
UM-CDC: Updated assumption on waning of 

vaccine efficacy per vaccine and outcome 

23

Hospitalization or ED: Initial VE (87.5% 

GSK; 84.6% Pfizer) assumed to persist 

for 7 months, to drop to 52.9% (GSK), 

75%(Pfizer) and remain flat from 

month 8 to month 18 (GSK) or month 

14 (Pfizer), and then decline linearly to 

0% at month 24.

Medically attended (Outpatient): 

Initial VE (79% GSK; 65.2% Pfizer) 

assumed to persist for 7 months, to 

drop to 27.8% (GSK), 55%(Pfizer) and 

remain flat from month 8 to month 18 

(GSK), month 14 (Pfizer), and then 

decline linearly to 0% at month 24 

GSK

Pfizer

87.5%

52.9%

79.0%

27.8%

84.6%

75.0%

65.2%

55.0%

The pink rectangle highlights the difference in duration of protection assumption between vaccines 
Comparison of GSK and Pfizer vaccines: Update base 

case & scenario $/QALY results using UM-CDC model

24

a Incidence rates: Lower incidence assumes 95% RT-PCR test sensitivity, Higher rate incorporates the upper limit of the 95% CI around the base case incidence rate 

estimate.

b Recommendation = vaccination at age ≥65 years; incidence rates of RSV outcomes upwardly adjust 1.5x to account for incomplete RT-PCR sensitivity on a 

respiratory specimen (McLaughlin et al; Open Forum Infect Dis 2022); vaccine efficacy only considered for two years post-vaccination

Scenario GSK Pfizer

Vaccinating adults aged 60 to <65 years only $372,656 $218,250

Lower incidence of RSVain adults ≥65 years $276,393 $161,487

Vaccine cost $340 per dose $220,864 $187,865

Vaccinating adults ≥60 years, $205,638 $118,735

Residual vaccine protection = 0% at 18 (GSK) or 14 (Pfizer) months $170,022 $135,886

Base caseb(Vacc price $270 GSK, $200 Pfizer, adults ≥65yrs) $167,301 $94,673

Vaccine cost $180 per dose $98,485 $81,358

Higherincidence of RSVbin adults ≥65 years $84,736 $40,467
Limitations

25

• Factors not considered that may result in overestimating the ICER 

(underestimating the cost-effectiveness) of RSV vaccination

• All of the 3 models assumed no indirect effects of vaccination (i.e., no protection against RSV 

transmission)

Except UM-CDC model

• Manufacturers models do not include RSV-related medical costs incurred after discharge 

from an RSV-associated hospitalization or emergency department visit: 

• Stay in long-term care or rehabilitation facility

• Manufacturers models do not include potential vaccine-associated serious 

adverse events (SAEs)

• Quality of life impact, resource utilization and costs associated with hypothetical SAEs 

• Vaccine efficacy beyond clinical trial follow-up time (beyond 14 months, Pfizer

or 18 months, GSK) is unknown

• All 3 models assumed non-zero declining efficacy beyond 14 or18 months 
Conclusion

26

• Differences in key inputs among GSK, Pfizer and UM-CDC models explain differences in results:

• Annual incidence of RSV hospitalization and outpatient disease

• Initial vaccine (season 1) and waning of protection (VE season 2+)

• Selection of medical costs sources and data extraction approach

• Resulting ICERs depended heavily on assumptions and selection of input data

• Annual incidence of RSV Hospitalization

• Vaccine costs (e.g., increase in GSK vaccine price)

• Base-case in the 3 models:

• Vaccination would significantly reduce RSV disease burden in older adults 

• VE clinical trials data and assumptions support impact on disease reduction

• Economic value of RSV vaccines appear to be costly and could be cost-effective 

• RSV incidence, related healthcare costs, initial VE and duration combined with reasonable 

vaccine price would determine the cost-effectiveness value of RSV vaccination
Acknowledgements 

From NCIRD/CDC

• Michael Melgar

• Jamison Pike

• Fiona Havers

• Amadea Britton

Also:

• Adult RSV working group members

• Andrew Leidner and the Econ Team members at ISD/NCIRD

27