ArticleBMC medicine2025
Influential drivers of the cost-effectiveness of respiratory syncytial virus vaccination in European older adults: a multi-country analysis.
Article in BMC medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Use of Health State Utility Values in Cost-Utility Analyses of Selected Infectious Diseases in Aging Populations: A Systematic Review and Critical Appraisal.PharmacoEconomics - open · 2026Pooled it
- Overview of adult immunization in Finland: Successes, lessons learned and the way forward.Human vaccines & immunotherapeutics · 2026Review
- Cost-Effectiveness of Bivalent Respiratory Syncytial Virus Prefusion F Vaccine for Older Adults in the Netherlands.Infectious diseases and therapy · 2026Article
- Article
- Hospitalization Burden Estimates of Respiratory Syncytial Virus With Adjustment for Case Underascertainment in Adults Aged 18 to 65 Years in High-Income Countries: A Systematic Review, Meta-Analysis, and Modeling Study.Open forum infectious diseases · 2026Article
- Resource use and economic burden of respiratory syncytial virus among older adults in real-world clinical practice across five European countries.Frontiers in public health · 2026Article
- Cost-Effectiveness Analysis of a Bivalent RSVPreF Vaccine in Japanese Adults Aged 60 Years and Older.Infectious diseases and therapy · 2025Article
- Review
Corrections and comments
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Authors and funding
14 authors.
Funding
Abstract
backgroundWe aimed to identify influential drivers of the cost-effectiveness of older adult respiratory syncytial virus (RSV) vaccination in Denmark, Finland, the Netherlands and Valencia-Spain.
methodsA static multi-cohort model was parameterised using country- and age-specific hospitalisations using three approaches: (A) the International Classification of Diseases (ICD)-coded hospitalisations, (B) laboratory RSV-confirmed hospitalisations and (C) time-series modelling (TSM). Plausible hypothetical RSV vaccine characteristics were derived from two protein subunit vaccines for adults aged ≥60 years. A full incremental analysis was conducted by comparing three RSV vaccination strategies: (1) in adults aged ≥60 years ("60y+"); (2) in adults aged ≥65 years ("65y+"); (3) in adults aged ≥75 years ("75y+") to "no intervention" and to each other. Both costs and quality-adjusted life-years (QALYs) were discounted at country-specific discount rates and the analysis was conducted from both the healthcare payers' and societal perspectives. Value of information, probabilistic sensitivity and scenario analyses identified influential drivers.
resultsBesides vaccine price, the hospitalisation estimates were most influential: (A) Using adjusted RSV-ICD-coded hospitalisations at a vaccine price of €150 per dose, no intervention was cost-effective up to willingness-to-pay (WTP) values of €150,000 per QALY gained in Denmark and the Netherlands, and up to €124,000 per QALY gained in Finland. (B) Using the adjusted RSV-confirmed dataset, the findings were consistent in Denmark and comparable in Finland. In Spain-Valencia, the 75y+ strategy became cost-effective at WTP >€55,000. (C) Using TSM-based estimates, the 75y+ strategy was cost-effective at WTP >€45,000, >€101,000, >€41,000 and >€114,000 in Denmark, Finland, the Netherlands and Spain-Valencia, respectively. Sensitivity analyses showed that the (in-hospital) case fatality ratio and the specification of its age dependency were both influential. Duration of protection was found more influential than a variety of plausible waning patterns over the duration of protection.
conclusionsData gaps and uncertainties on the RSV-related burden in older adults persist and influence the cost-effectiveness of RSV vaccination. More refined age- and country-specific data on the RSV attributable burden are crucial to aid decision making.
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