Influential drivers of the cost-effectiveness of respiratory syncytial virus vaccination in European older adults: a multi-country analysis

作者：Xiao Li, Lander Willem, Caroline Klint Johannesen, Arantxa Urchueguía-Fornes, Toni Lehtonen, Richard Osei‐Yeboah, Heini Salo, Alejandro Orrico‐Sánchez, Javier Díez‐Domingo, Mark Jit, for PROMISE investigators, Harish Nair, Harry Campbell, Louis Bont, Philippe Beutels, Peter Openshaw, Andrew J. Pollard, Hanna Nohynek, John Paget, Eva Molero, Javier Díez‐Domingo, Rolf Kramer, Jim Janimak, Veena Kumar, Elizabeth Begier, Jenny Hendri, Joke Bilcke, Harish Nair, Philippe Beutels · 发表于：BMC Medicine · 年份：2025 · DOI：10.1186/s12916-025-03970-x · 被引用次数：8 · 研究领域：Respiratory viral infections research、SARS-CoV-2 and COVID-19 Research、Cystic Fibrosis Research Advances

BACKGROUND: We 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. METHODS: A 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. RESULTS: Besides 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 Finla...