DOI: 10.6084/m9.figshare.29458627.v1
title: Budget impact of maternal vaccination with RSVpreF to protect privately insured infants in Dubai against respiratory syncytial virus

description: Respiratory syncytial virus (RSV) manifesting as lower respiratory tract illness (LRTI; RSV-LRTI) represents a significant healthcare burden among infants in Dubai and worldwide. The novel bivalent stabilized prefusion F subunit vaccine (RSVpreF) for administration among pregnant women to protect infants against RSV-LRTI has been evaluated and approved for use in Dubai. We assessed the budget impact of year-round maternal RSVpreF use to prevent RSV-LRTI among privately insured non-Emirati infants living in Dubai. A deterministic cohort model was built to illustrate clinical and economic outcomes of RSV-LRTI among infants from birth to age 1 year for five annual birth cohorts. Model population comprised infants born to non-Emirati pregnant women; parameter values were estimated principally based on published sources using Dubai-specific data to the extent possible. Model outcomes included cases of disease (hospital, emergency department, outpatient clinic), disease-attributable deaths, and costs of disease and vaccination (in US$). Budget impact was reported in terms of overall cost and per-member per-year (PMPY) cost. With no intervention, there would be 23,267 RSV-LRTI cases (1,960 hospital; 5,655 emergency department 15,652 outpatient) and medical costs would total $11.5 M over 5 years. Targeting 10% of pregnant women with RSVpreF would prevent 855 cases and reduce infant medical care costs by $0.5 M. With vaccination costs estimated at $3.6 M, overall costs would increase by $3.1 M overall and $0.19 PMPY. Findings suggest that RSVpreF use among pregnant women would substantially reduce the clinical and economic burden of RSV-LRTI in infants, requiring an investment of just $0.19 PMPY by private health insurers. <b>Title</b>. Costs to Private Insurers in Dubai for Vaccinating Non-Emirati Pregnant Women to Protect Infants Against Respiratory Syncytial Virus: a Modeling Study. <b>Summary</b>. Respiratory syncytial virus (RSV) is a common cause of lower respiratory tract illness (LRTI; RSV-LRTI) among infants and young children. A new vaccine (herein “RSVpreF”) for pregnant women may reduce cases of RSV-LRTI as well as associated treatment costs among infants. We used a Microsoft Excel-based model to estimate the burden of RSV-LRTI among non-Emirati infants aged &lt; 1 year in Dubai with private insurance. Outcomes included total cases and costs (including costs of vaccination). Our model assumed there were 26,531 pregnant women giving birth to 27,257 liveborn infants annually. We estimated results for two alternative scenarios over a 5-year period: 1) assuming 10% of pregnant women received RSVpreF; and 2) assuming 0% of pregnant women received RSVpreF. Results from each scenario were compared by calculating differences in total cases and costs. Without use of RSVpreF among pregnant women, there were 23,267 cases of RSV over 5 years; corresponding treatment costs totaled $11.5 M. Administering RSVpreF to 10% of pregnant women would prevent 855 cases of RSV-LRTI, corresponding to a $0.5 M reduction in treatment costs among protected infants. However, due to the added cost of vaccination ($3.6 M in total), the net cost of vaccination would be $3.1 M. Spread over all non-Emirati beneficiaries of private health plans in Dubai – including infants, pregnant women, and other adults and children of all ages – the total cost of RSVpreF vaccination would be $0.19 per-member per-year.