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Introduction <p>Lower respiratory tract disease caused by respiratory syncytial virus (RSV-LRTD) is associated with substantial clinical and economic burden among older adults and adults with chronic medical conditions. Bivalent RSV prefusion F protein-based vaccine (RSVpreF) has been authorized for use among all adults aged ≥ 60&#xa0;years in the Netherlands, and The Health Council of the Netherlands has recommended RSV vaccination for at-risk persons aged 60–74&#xa0;years and all persons aged ≥ 75&#xa0;years. We estimated the cost-effectiveness of implementing this strategy.</p> Methods <p>We have developed a static cohort model to demonstrate lifetime clinical and economic outcomes associated with RSV-LRTD among adults in the Netherlands, with (vs. without) RSVpreF use (price: €180; age/risk-specific uptake: 44.6–80.4%). Model inputs include population characteristics, disease rates [hospitalization (RSV-H), general practitioner visit (RSV-GP), non-medically attended (RSV-NMA)], fatality rates, vaccine effectiveness (based on real-world and clinical trial data), utilities/disutilities, medical care costs, indirect costs associated with morbidity- and mortality-related productivity loss, and vaccination costs. Discounting was applied to costs (3%) and benefits (1.5%).</p> Results <p>Among at-risk adults aged 60–74&#xa0;years and all adults aged ≥ 75&#xa0;years (<i>n</i> = 4.8 million) in the Netherlands, single-dose RSVpreF would prevent 84,228 RSV-LRTD cases (RSV-H: 16,642, RSV-GP: 21,788, RSV-NMA: 45,798) and 2304 RSV-LRTD deaths over a lifetime horizon. With 11,006 quality-adjusted life-years (QALY) gained and a €195 million increase in total costs, incremental cost-effectiveness ratio for RSVpreF would be €17,740/QALY gained. RSVpreF would thus prevent 16% of hospitalizations, 15% of deaths, 16% of medical costs, and 20% of indirect costs related to RSV among this population over their remaining lifetime. In probabilistic sensitivity analyses applying variability to key inputs, all 1000 replications yielded cost-effectiveness ratios within the Health Council’s willingness-to-pay threshold (&lt; €50,000/QALY gained).</p> Conclusions <p>Findings suggest that RSVpreF would greatly reduce the clinical and economic burden of RSV among older adults in the Netherlands.</p>

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Cost-Effectiveness of Bivalent Respiratory Syncytial Virus Prefusion F Vaccine for Older Adults in the Netherlands

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月24日

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  • Annefleur C. Langedijk,
  • Floris van den Dungen,
  • Frits M. E. Franssen,
  • Marco Goeijenbier,
  • Ahuva Averin,
  • Erin Quinn,
  • Mark Atwood,
  • Diana Mendes

摘要

Introduction

Lower respiratory tract disease caused by respiratory syncytial virus (RSV-LRTD) is associated with substantial clinical and economic burden among older adults and adults with chronic medical conditions. Bivalent RSV prefusion F protein-based vaccine (RSVpreF) has been authorized for use among all adults aged ≥ 60 years in the Netherlands, and The Health Council of the Netherlands has recommended RSV vaccination for at-risk persons aged 60–74 years and all persons aged ≥ 75 years. We estimated the cost-effectiveness of implementing this strategy.

Methods

We have developed a static cohort model to demonstrate lifetime clinical and economic outcomes associated with RSV-LRTD among adults in the Netherlands, with (vs. without) RSVpreF use (price: €180; age/risk-specific uptake: 44.6–80.4%). Model inputs include population characteristics, disease rates [hospitalization (RSV-H), general practitioner visit (RSV-GP), non-medically attended (RSV-NMA)], fatality rates, vaccine effectiveness (based on real-world and clinical trial data), utilities/disutilities, medical care costs, indirect costs associated with morbidity- and mortality-related productivity loss, and vaccination costs. Discounting was applied to costs (3%) and benefits (1.5%).

Results

Among at-risk adults aged 60–74 years and all adults aged ≥ 75 years (n = 4.8 million) in the Netherlands, single-dose RSVpreF would prevent 84,228 RSV-LRTD cases (RSV-H: 16,642, RSV-GP: 21,788, RSV-NMA: 45,798) and 2304 RSV-LRTD deaths over a lifetime horizon. With 11,006 quality-adjusted life-years (QALY) gained and a €195 million increase in total costs, incremental cost-effectiveness ratio for RSVpreF would be €17,740/QALY gained. RSVpreF would thus prevent 16% of hospitalizations, 15% of deaths, 16% of medical costs, and 20% of indirect costs related to RSV among this population over their remaining lifetime. In probabilistic sensitivity analyses applying variability to key inputs, all 1000 replications yielded cost-effectiveness ratios within the Health Council’s willingness-to-pay threshold (< €50,000/QALY gained).

Conclusions

Findings suggest that RSVpreF would greatly reduce the clinical and economic burden of RSV among older adults in the Netherlands.