Report of the WHO technical consultation on the evaluation of respiratory syncytial virus prevention cost effectiveness in low- and middle-income countries, April 7-8, 2022.

Policymakers often rely on impact and cost-effectiveness evaluations to inform decisions about the introduction of health interventions in low- and middle-income countries (LMICs); however, cost-effectiveness results for the same health intervention can differ by the choice of parameter inputs, modelling assumptions, and geography. Anticipating the near-term availability of new respiratory syncytial virus (RSV) prevention products, WHO convened a two-day virtual consultation in April 2022 with stakeholder groups and global experts in health economics, epidemiology, and vaccine implementation. The objective was to review methods, parameterization, and results of existing cost-effectiveness analyses for RSV prevention in LMICs; identify the most influential inputs and data limitations; and recommend and prioritize future data gathering and research to improve RSV prevention impact estimates in LMICs. Epidemiological parameters identified as both influential and uncertain were those associated with RSV hospitalization and death, specifically setting-specific hospitalization rates and RSV-attributable death rates. Influential economic parameters included product price, delivery costs, willingness-to-pay for health on the part of potential donors, and the cost of RSV-associated hospitalization. Some of the influential parameters identified at this meeting should be more precisely measured by further research. Other influential economic parameters that are highly uncertain may not be resolved, and it is appropriate to use sensitivity analyses to explore these within cost-effectiveness evaluations. This report highlights the presentations and major discussions of the meeting.

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Copyright © 2023. Published by Elsevier Ltd.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [Meagan C. Fitzpatrick: received grants to her institution from the National Institutes of Health, National Science Foundation, World Health Organization, and Bill & Melinda Gates Foundation; consulting fees from Sanofi Pasteur and The Commonwealth Fund. Rachel S. Laufer: none to declare. Ranju Baral: none to declare. Amanda Driscoll: none to declare. Danny Feikin : none to declare. Jessica A. Fleming: none to declare. Mark Jit: Mark Jit is an unpaid member of the Respiratory Syncytial Virus Consortium in Europe (RESCEU) and Preparing for RSV Immunisation and Surveillance in Europe (PROMISE). RESCEU and PROMISE have received funding from the Innovative Medicines Initiative 2 Joint Undertaking. This Joint Undertaking receives support from the European Union’s Horizon 2020 research and innovation program and the European Federation of Pharmaceutical Industries and Associations. Neither MJ nor his research group has received any forms of pecuniary or other support from the pharmaceutical industry. Sonnie Kim: none to declare. Mihaly Koltai: none to declare. You Li: Grants to his institutions from Wellcome Trust and GSK; personal fees from Pfizer, all outside the submitted work. Xiao Li: none to declare. Harish Nair: Received funding from Innovative Medicines Initiative, National Institute of Health Research, Pfizer, and Icosavax; Consultancies from Sanofi, Pfizer, GSK, MSD, ReViral, Icosavax, Astra Zeneca, and Abbvie all outside submitted work. Kathleen M. Neuzil: Is a member of the WHO Strategic Advisory Group of Experts on Immunization. Clint Pecenka: none to declare. Erin Sparrow: none to declare. Padmini Srikantiah: none to declare. Justin R. Ortiz: Grants to his institution from the National Science Foundation, Bill & Melinda Gates Foundation, Pfizer, NIH, and World Health Organization; consulting fees from Putnam and GSK; and participation on advisory boards for Pfizer, Seqirus, and Moderna, all outside the submitted work].