Poster Presentation Asia-Pacific Vaccine and Immunotherapy Congress 2026

Clinical and Economic Benefits of Bivalent Respiratory Syncytial Virus Prefusion F (RSVpreF) Vaccine for Prevention of RSV in Older Adults: A Cost-Effectiveness Analysis for Singapore (#152)

Karan Thakkar 1 , Robin Kendall 2 , Nishu Gaind 2 , Luka Ivkovic 2 , Gopika Balasubramanian 2 , Rengina Kefalogianni 3 , Jingwen Zhang 1 , Kay Choong See 4 , Andrea Lay-Hoon Kwa 5 6 , Diana Mendes 3 , Janice Yeoh 1
  1. Pfizer, Singapore
  2. Evidinno Outcomes Research Inc., Vancouver, British Columbia (BC), Canada
  3. Pfizer Ltd, Tadworth, Surrey, United Kingdom
  4. Division of Respiratory & Critical Care Medicine, National University Hospital, Singapore
  5. Division of Pharmacy, Singapore General Hospital, Singapore
  6. Emerging Infectious Diseases Programme, Duke-National University of Singapore Medical School, Singapore

Background: Respiratory syncytial virus (RSV) is a common respiratory virus which can cause severe illness in adults. A novel RSVpreF vaccine was recently approved by the Health Sciences Authority in Singapore for adults aged 60 years and older for the prevention of lower respiratory tract disease caused by RSV. Hence, the clinical and economic burden of RSV among older adults in Singapore, with and without a year-round RSVpreF vaccination programme, was estimated.

Methods: A Markov model projected the lifetime clinical and economic outcomes of RSV in adults with and without RSVpreF vaccination. Inputs were collected from publicly available sources. Clinical trial efficacy data was used and vaccine uptake was assumed equivalent to influenza vaccination rates in Singapore. Analyses were conducted from the healthcare and societal perspectives, incorporating direct and indirect costs (2024 Singapore dollars [SGD]) and future outcomes discounted at 3% annually. Sensitivity analyses assessed the model robustness.

Results: Among adults aged 60-74 years at increased risk of severe RSV disease and all adults 75 years and older, the estimated burden without intervention included 54,595 RSV hospitalizations, 33,193 RSV emergency department (ED) cases, and 339,953 RSV cases requiring physician office (PO) visit, with total medical care costs of SGD299.27 million over the cohort lifetime. Assuming 40.6% uptake, RSVpreF vaccination would prevent 2,291 hospitalizations, 1,426 ED cases, and 8,784 PO cases, saving SGD15.63 million in medical costs. With 1,417 quality-adjusted life years (QALYs) gained, assuming SGD273/dose, the incremental cost-effectiveness ratio was SGD47,679/QALY gained, well below Singapore’s cost-effectiveness threshold. RSVpreF would remain cost-effective up to SGD542/dose assuming a threshold of 1xGDP per capita (SGD113,778). From a societal perspective, RSVpreF would be cost saving compared to no intervention.

Conclusions: Year-round RSVpreF vaccination would substantially reduce RSV’s clinical and economic burden among older adults in Singapore and likely be a highly cost-effective programme.