Disease burden estimates in economic evaluation studies of respiratory syncytial virus (RSV) maternal immunization: a systematic review

Recently, new technologies have emerged for the prevention of respiratory syncytial virus (RSV) infections. Reliable epidemiological data are essential for accurately assessing the disease burden and informing health economic evaluations (HEE). This review evaluates how HEE of RSV maternal vaccination (MV) estimated the RSV disease burden. A systematic search was conducted in MEDLINE, SCOPUS, EMBASE, NHS EED, HTA, Tufts CEA Registry, LILACS, and Web of Science for full HEE of RSV MV. Reporting quality was assessed with the CHEERS 2022 checklist, costs were converted to 2024 U.S. dollars, and a descriptive, interpretive synthesis of the data was performed. All 21 included studies were cost-utility analyses, 10 conducted in high-income countries. The HEE utilized a wide range of data sources to build epidemiological estimates, frequently relying on non-local data, particularly for outpatient rates. National data on RSV hospitalization rates were the most commonly available. No study included equity assessments. The maternal vaccine dose price was identified as a critical factor in the strategy’s cost-effectiveness. Enhancing local data availability for RSV, by strengthening the respiratory virus surveillance, is crucial to improve the reliability of HEE of RSV prevention strategies and enable more informed and effective policy decisions. PROSPERO: CRD42024549989.