ArticleFrontiers in public health2026
Unlocking the value of RSV vaccination in Japan: a return on investment analysis using an integrated actuarial-macroeconomic model.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
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.
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