Evaluating the societal value of adult respiratory vaccination in Sweden: a benefit-cost analysis.

Quantifying the societal benefits of adult immunization against respiratory diseases in France: a benefit cost analysis.

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.

Cost-Effectiveness Analysis of the mRNA-1345 RSV Vaccine for Older Adults in Italy

Cost-effectiveness of respiratory syncytial virus vaccination for older adults: a modelling analysis

Background. Evidence of the effectiveness and cost-effectiveness of new vaccines that reduce the burden of respiratory syncytial virus (RSV) in older populations is emerging. The reported cost-effectiveness of these vaccination strategies varies substantially across different settings. This study assessed the cost-effectiveness of older adult-targeted RSV vaccination strategies in the Australian context and compared findings with published evaluations. Methods. We developed an individual-based dynamic transmission model of RSV infection, linked to a clinical pathways and cost-effectiveness model. We modelled different adult vaccination strategies for the general population and the Indigenous population, and present incremental cost-effectiveness ratios (ICERs) as cost per quality-adjusted life year gained, from a healthcare system perspective. Deterministic and probabilistic sensitivity analyses explored drivers of cost-effectiveness and sensitivity of findings to uncertainty in parameter estimates. Results. Vaccinating the general population of older adults in Australia was not found to be cost-effective at a dose price of 100 AUD, but was found to be cost-saving for Indigenous adults, given the higher disease burden in this population. Individual drivers of ICERs in our setting were dose price, hospitalisation incidence and mortality, however conclusions about cost-effectiveness were robust to joint parameter uncertainty. Conclusions. The cost-effectiveness of vaccinating adults against RSV depends on many uncertain and context-specific quantities. Strategies that target high risk populations were found to be cost-effective in Australia due to the larger avertable burden.

Pneumococcal infection in the elderly: cost-effectiveness of vaccination to reduce demographic losses

Vaccination of Russian people aged ≥60 years with PCV20 provides the greatest reduction in pneumococcal infection incidence and is highly cost-effective compared to PPV23 vaccination and is cost-effective compared to sequential PCV13/PPV23 vaccination.

Economic evaluation of alternative PCV13 vaccination strategies in Guangxi, China: a decision tree-Markov model study.

BACKGROUND Pneumococcal disease remains a major cause of morbidity and mortality among children under five years of age, particularly in settings with low vaccine coverage. In China, the 13-valent pneumococcal conjugate vaccine (PCV13) is not included in the National Immunization Program (NIP), resulting in suboptimal uptake. This study evaluated the health and economic impact of including PCV13 in the immunization program in Guangxi Zhuang Autonomous Region. METHODS A decision tree-Markov model was used to simulate a birth cohort of 420,000 children over a 5-year horizon from a societal perspective. The current self-paid vaccination strategy was compared with NIP inclusion. Outcomes included costs, cases, deaths, quality-adjusted life years (QALYs), incremental cost-effectiveness ratios (ICERs), and benefit-cost ratios (BCRs). Costs and outcomes were discounted at 3%. One-way and probabilistic sensitivity analyses were conducted. RESULTS NIP inclusion increased vaccination coverage from 5900 to 417,019 children and was projected to prevent 77,042 cases and 327 deaths over 5 years. Despite higher vaccination costs, reduced disease burden resulted in a net economic benefit of USD 3.92 million (BCR: 1.03). The program generated an additional 25,702.2 QALYs, with an ICER of USD 6042.75 per QALY gained, below the per capita GDP threshold. Probabilistic sensitivity analysis showed that most simulations were below the willingness-to-pay threshold, with the probability of cost-effectiveness approaching 100%. CONCLUSIONS Including PCV13 in Guangxi's immunization program is highly cost-effective and likely to yield positive economic returns. These findings are robust and support policy decisions on PCV13 inclusion.

Unlocking the value of RSV vaccination in Japan: a return on investment analysis using an integrated actuarial-macroeconomic model

Objective Respiratory syncytial virus (RSV) causes significant morbidity and mortality among older adults and individuals with chronic conditions. This study conducted a cost–benefit analysis (CBA) to evaluate the societal value of RSV vaccination with the adjuvanted RSV prefusion F protein (RSVPreF3) vaccine among older adults aged ≥60 years and high-risk adults aged 50–59 years in Japan. Methods An actuarial population projection model, combined with a full CBA framework adapted to the Japanese setting, was used to estimate costs and benefits of adjuvanted RSVPreF3 vaccination versus no vaccination over a 10-year time horizon. Deterministic sensitivity analyses were conducted to assess parameter uncertainty. Results Our results indicate that a 5-year vaccination program among older adults, including those aged 50–59 years at higher risk for severe RSV disease and those aged ≥60 years, was associated with substantial economic benefits. Among older adults aged ≥60 years, the total return on investment (ROI) was 3.3 with or without deadweight loss (DWL), with vaccination projected to avert Japanese Yen (JPY) 35,501 M in productive output loss, save JPY 1,178,403 M in direct healthcare costs, and prevent JPY 10,699,729 M in monetized quality-adjusted life-year (QALY) loss. For high-risk adults aged 50–59 years, the total ROI was 3.7 without DWL and 3.8 with DWL, with corresponding reductions of JPY 17,889 M in productive output loss, JPY 10,400 M in healthcare costs, and JPY 266,116 M in monetized QALY loss. Conclusion Overall, adjuvanted RSVPreF3 vaccination among older adults in Japan represents good value for money from a societal perspective, where vaccine acquisition and administration costs are expected to be outweighed by substantial health, productivity, and broader economic benefits.