BACKGROUND
Pneumococcal disease, respiratory syncytial virus (RSV), influenza, and COVID-19 place a significant burden on France's population health, health system, and economy. Older adults and adults in clinical risk groups are recommended to receive vaccination against these illnesses, although RSV is not reimbursed.
RESEARCH DESIGN AND METHODS
A benefit-cost analysis was conducted to assess the societal return on investment from adult vaccination by estimating benefit-cost ratios (BCRs) and net benefits (NBs). Health outcomes were monetized using established methods. Program costs included all direct vaccination-related expenditures. Scenario and sensitivity analyses assessed alternative program specifications and tested the robustness of the model.
RESULTS
France's age-based respiratory immunization programs generate a BCR of €2.0 to €8.7 per €1 spent over the lifetime, depending on mortality risk reduction monetization. This corresponds to NBs of €9.7 to €72.6 billion. Introducing adult RSV vaccination with a similar uptake to that in the US could increase NBs by approximately 6%-7% compared to the status quo. Achieving aspirational coverage targets across all programs would increase NBs by 138%-175%.
CONCLUSIONS
France's adult respiratory vaccination programs generate positive socioeconomic returns. Including adult RSV vaccination and increasing vaccination uptake would further increase their societal benefits. Realizing these gains requires adequate public investment.
Matthew Napier, S. Brassel, E. Tunnicliffe et al.· Expert Review of Vaccines· 0 citations
OBJECTIVES
Most of the clinical and economic burden of the respiratory syncytial virus (RSV) in pediatric populations is concentrated among infants aged <1 year. Since 2024, RSVpreF vaccine is available in France for the vaccination of pregnant women between 32 and 36 weeks of gestational age, from September to January. This study aimed to model the impact of alternative RSVpreF national vaccination strategies on RSV hospital burden.
METHODS
A three-state Markov model - Susceptible to be infected, RSV-related hospitalization, and Death - was developed to assess the number of hospitalizations avoided by alternative vaccination strategies. The model population of 627,499 unique births in one year was split in two cohorts of infants born to vaccinated and unvaccinated women. Four strategies were modeled: no vaccination, vaccination between September and January (recommended), between May and January (extended), and year-round. Results were presented at a population level using a healthcare perspective, as cost per hospitalization avoided, and number needed to vaccinate (NNV).
RESULTS
In the absence of vaccination, 38,625 RSV-related hospitalization among infants under 1 year of age were estimated annually, costing €120.0 million. Compared to no vaccination, the recommended strategy prevented 7,620 (-19.7%) RSV-related hospitalizations, 90.4% of them involved infants aged <3 months (99.5% aged <6 months). The related total cost was €126.4 million, corresponding to cost of €844 per hospitalization avoided, and an NNV of 21 vaccinations to avoid one hospitalization. Compared to the recommended strategy, the extended strategy avoided an additional 4,111 (-13.3%) hospitalizations, 42.0% of them involving infants aged <3 months (95.0% aged <6 months). The total cost of this strategy was €134.4 million (+6.3%), corresponding to a cost of €1,929 per additional hospitalization avoided. Total cost of the year-round strategy was €156.2 million, for 1,306 additional hospitalizations avoided.
CONCLUSIONS
This is the first cost-effectiveness model to describe the public health impact of alternative vaccination strategies for RSV prevention in France. The number of hospitalizations avoided ranged from 7,600 stays in the recommended strategy, to more than 13,000 in the year-round strategy, corresponding to hospital savings between €24.7 million and €41.5 million. Alternative scenarios were shown to extend prevention to older age groups. Broader vaccination strategies, notably the extended strategy, had a positive impact on RSV hospital burden, with a limited impact on total costs.
Y. Fahfouhi, S. Fiévez, R. Cohen et al.· Vaccine· 0 citations
PCV20 is a cost-saving alternative to the PCV13 → PPV23 sequence for at-risk adults in France and provides substantial public health gains and represents a highly cost-effective strategy relative to commonly cited French vaccine HTA benchmarks.
S. Fiévez, Mélanie Menara, E. Blanc et al.· BMC Public Health· 0 citations
