British drugmaker GSK said today that the US Food and Drug Administration (FDA) has expanded the approved use of its respiratory syncytial virus (RSV) vaccine for younger adults at risk of complications from the virus.

In a news release, the company said the FDA approved Arexvy for use in adults aged 18 to 49 who are at increased risk of lower respiratory tract disease (LRTD) caused by RSV. The vaccine was previously approved for all adults aged 60 and over and those aged 50 to 59 at increased risk of LRTD caused by RSV.

2 million clinic visits a year

RSV is associated with an estimated 17,000 hospitalizations, 277,000 emergency department admissions, and 1.97 million outpatient visits annually in adults aged 18 to 49, according to a study cited in the release. Hospitalizations are more likely to occur in younger adults with chronic medical conditions that can be exacerbated by RSV, such as cardiopulmonary or kidney disease, obesity, and diabetes.

GSK said the expanded approval is based on data from a phase 3b trial that showed a non-inferior immune response to the vaccine in younger adults compared with those 60 and older.

“This age expansion can help address a significant medical need for adults in the United States at higher risk of severe RSV disease due to certain underlying conditions, and help ease pressure on the healthcare system,” said Sanjay Gurunathan, MD, GSK’s head of vaccines and infectious diseases research and development.

A study today by Canadian researchers suggests an antibiotic audit and feedback (A&F) program for primary care physicians is associated with “substantial” economic and clinical value.

For the study, a team led by researchers with the Ottawa Hospital Research Institute and Public Health Ontario analyzed data from a previously conducted randomized clinical trial involving nearly 5,000 primary care physicians in Ontario. That trial, whose results were published in 2024, found that the physicians who received a mailed letter comparing their antibiotic prescribing rate to that of their peers had a 5% lower antibiotic prescribing rate in patients aged 65 and older compared with physicians who didn’t receive the letter. The aim of the current study was to determine the return-on-investment (ROI) from the program.

Linking data from the trial with health care use and cost data from the Institute for Clinical and Evaluative Services in Toronto, the researchers developed a decision model to calculate monetary costs and benefits of the intervention. The benefits were quantified as the monetary value of avoiding antibiotics and antibiotic-associated adverse events, such as diarrhea, versus the costs of potential harms from undertreatment.

“While evidence on the effectiveness of audit and feedback interventions is growing, policymakers and stewardship teams require accumulating economic evidence to support sustained investment and broader implementation of these A&F programs,” the study authors wrote in JAMA Network Open.

Economic and patient safety benefits

The cost to run the program was $5.50 ($ 4.01 USD) per physician and generated $43.03 ($31.34) in savings per physician from reduced antibiotic use and reduced health care use for adverse events, resulting in an ROI of $8.82 ($6.42) for every dollar invested. In a scenario in which all 40,000 primary care physicians in Canada were enrolled in the program, the researchers estimated an ROI of $16.82 ($12.25).

The authors say the findings highlight “both the economic and patient safety benefits of the A&F program.”

“These findings support the integration of antibiotic A&F interventions into routine primary care as a scalable strategy to advance antimicrobial stewardship, improve prescribing practices, and enhance the sustainability of health care delivery,” they concluded.

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• After a 58% reduction in support from France and a delayed pledge from the European Union, the Global Fund is looking at a $5 billion shortfall, according to Health Policy Watch. The organization, which raises money to fight HIV, tuberculosis, and malaria, has secured $12.6 billion, short of its $18 billion target. Reaching the target would have prevented about 400 million cases of the three diseases from 2027 to 2029, the Global Fund said. To manage the funding gap, the board approved $10.8 billion in core-country allocations for that period.