Evaluating cost-effectiveness of RSV vaccination strategies for older adults in the Netherlands

Florian Zeevat; Jos Luttjeboer; Koos Korsten; Michiel van Boven; Maarten J. Postma; Simon van der Pol; Cornelis Boersma

doi:10.1016/j.vaccine.2025.127735

Evaluating cost-effectiveness of RSV vaccination strategies for older adults in the Netherlands

Florian Zeevat^*, Jos Luttjeboer, Koos Korsten, Michiel van Boven, Maarten J. Postma, Simon van der Pol, Cornelis Boersma

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

OBJECTIVE: This study evaluates the cost-effectiveness of respiratory syncytial virus (RSV) vaccination for older adults in the Netherlands, aiming to identify the most effective vaccination strategy.

METHODS: A static decision tree cost-effectiveness model was developed to compare no vaccination with various RSV vaccination strategies for Dutch adults over six RSV seasons. Strategies included vaccinating adults aged ≥60, ≥75, and ≥75 combined with high-risk individuals aged 60-74. Each was assessed with two- and three-year intervals. The model incorporated health outcomes and costs associated with RSV disease and vaccination from a societal perspective, with a lifetime horizon. Recent incidence data were used, and vaccine effectiveness was based on efficacy from a meta-analysis for outpatient settings and real-world effectiveness data for inpatient settings. A probabilistic sensitivity analysis was conducted, using a €50,000 per quality-adjusted life year (QALY) willingness-to-pay threshold.

RESULTS: Vaccinating individuals aged ≥75 years and high-risk groups every three years could prevent approximately 19,000 general practitioner visits, 3300 hospitalizations (including 245 intensive care admissions), and 870 deaths in the first year. This strategy would avoid €29.5 million in healthcare costs and €6.3 million in productivity losses, gaining 2900 QALYs. It was cost-effective, with an average cost-effectiveness ratio (ACER) of €30,804/QALY. The most cost-effective strategy was vaccinating ≥75 year-olds every three years, with an incremental cost-effectiveness ratio (ICER) of 23,080/QALY compared to no vaccination. Vaccinating all ≥60-year-olds every three years resulted in the highest QALY gain, with an ACER of €39,918/QALY. Compared to the ≥75 and high-risk strategy, this approach had an ICER of €107,623/QALY, whereas the 75+ and high-risk strategy had an ICER of €61,987/QALY compared to the ≥75 strategy alone. Biennial strategies were associated with higher ACERs and were dominated in incremental comparisons.

CONCLUSION: RSV vaccination for older adults in the Netherlands can be cost-effective, particularly when vaccinating every three years.

Original language	English
Article number	127735
Number of pages	12
Journal	Vaccine
Volume	65
DOIs	https://doi.org/10.1016/j.vaccine.2025.127735
Publication status	Published - 24 Oct 2025

Keywords

Cost-effectiveness
Older adults
Rsv
Vaccination strategy
Quality-Adjusted Life Years
Vaccination/economics
Humans
Middle Aged
Male
Vaccine Efficacy
Respiratory Syncytial Virus Vaccines/economics
Respiratory Syncytial Virus Infections/prevention & control
Cost-Benefit Analysis
Aged, 80 and over
Female
Aged
Netherlands/epidemiology

Access to Document

10.1016/j.vaccine.2025.127735

Cite this

@article{3db960b7e32e4a269f96ecc6f1b58825,

title = "Evaluating cost-effectiveness of RSV vaccination strategies for older adults in the Netherlands",

abstract = "OBJECTIVE: This study evaluates the cost-effectiveness of respiratory syncytial virus (RSV) vaccination for older adults in the Netherlands, aiming to identify the most effective vaccination strategy.METHODS: A static decision tree cost-effectiveness model was developed to compare no vaccination with various RSV vaccination strategies for Dutch adults over six RSV seasons. Strategies included vaccinating adults aged ≥60, ≥75, and ≥75 combined with high-risk individuals aged 60-74. Each was assessed with two- and three-year intervals. The model incorporated health outcomes and costs associated with RSV disease and vaccination from a societal perspective, with a lifetime horizon. Recent incidence data were used, and vaccine effectiveness was based on efficacy from a meta-analysis for outpatient settings and real-world effectiveness data for inpatient settings. A probabilistic sensitivity analysis was conducted, using a €50,000 per quality-adjusted life year (QALY) willingness-to-pay threshold.RESULTS: Vaccinating individuals aged ≥75 years and high-risk groups every three years could prevent approximately 19,000 general practitioner visits, 3300 hospitalizations (including 245 intensive care admissions), and 870 deaths in the first year. This strategy would avoid €29.5 million in healthcare costs and €6.3 million in productivity losses, gaining 2900 QALYs. It was cost-effective, with an average cost-effectiveness ratio (ACER) of €30,804/QALY. The most cost-effective strategy was vaccinating ≥75 year-olds every three years, with an incremental cost-effectiveness ratio (ICER) of 23,080/QALY compared to no vaccination. Vaccinating all ≥60-year-olds every three years resulted in the highest QALY gain, with an ACER of €39,918/QALY. Compared to the ≥75 and high-risk strategy, this approach had an ICER of €107,623/QALY, whereas the 75+ and high-risk strategy had an ICER of €61,987/QALY compared to the ≥75 strategy alone. Biennial strategies were associated with higher ACERs and were dominated in incremental comparisons.CONCLUSION: RSV vaccination for older adults in the Netherlands can be cost-effective, particularly when vaccinating every three years.",

keywords = "Cost-effectiveness, Older adults, Rsv, Vaccination strategy, Quality-Adjusted Life Years, Vaccination/economics, Humans, Middle Aged, Male, Vaccine Efficacy, Respiratory Syncytial Virus Vaccines/economics, Respiratory Syncytial Virus Infections/prevention \& control, Cost-Benefit Analysis, Aged, 80 and over, Female, Aged, Netherlands/epidemiology",

author = "Florian Zeevat and Jos Luttjeboer and Koos Korsten and \{van Boven\}, Michiel and Postma, \{Maarten J.\} and \{van der Pol\}, Simon and Cornelis Boersma",

year = "2025",

month = oct,

day = "24",

doi = "10.1016/j.vaccine.2025.127735",

language = "English",

volume = "65",

journal = "Vaccine",

issn = "0264-410X",

publisher = "Elsevier Ltd",

}

TY - JOUR

T1 - Evaluating cost-effectiveness of RSV vaccination strategies for older adults in the Netherlands

AU - Zeevat, Florian

AU - Luttjeboer, Jos

AU - Korsten, Koos

AU - van Boven, Michiel

AU - Postma, Maarten J.

AU - van der Pol, Simon

AU - Boersma, Cornelis

PY - 2025/10/24

Y1 - 2025/10/24

N2 - OBJECTIVE: This study evaluates the cost-effectiveness of respiratory syncytial virus (RSV) vaccination for older adults in the Netherlands, aiming to identify the most effective vaccination strategy.METHODS: A static decision tree cost-effectiveness model was developed to compare no vaccination with various RSV vaccination strategies for Dutch adults over six RSV seasons. Strategies included vaccinating adults aged ≥60, ≥75, and ≥75 combined with high-risk individuals aged 60-74. Each was assessed with two- and three-year intervals. The model incorporated health outcomes and costs associated with RSV disease and vaccination from a societal perspective, with a lifetime horizon. Recent incidence data were used, and vaccine effectiveness was based on efficacy from a meta-analysis for outpatient settings and real-world effectiveness data for inpatient settings. A probabilistic sensitivity analysis was conducted, using a €50,000 per quality-adjusted life year (QALY) willingness-to-pay threshold.RESULTS: Vaccinating individuals aged ≥75 years and high-risk groups every three years could prevent approximately 19,000 general practitioner visits, 3300 hospitalizations (including 245 intensive care admissions), and 870 deaths in the first year. This strategy would avoid €29.5 million in healthcare costs and €6.3 million in productivity losses, gaining 2900 QALYs. It was cost-effective, with an average cost-effectiveness ratio (ACER) of €30,804/QALY. The most cost-effective strategy was vaccinating ≥75 year-olds every three years, with an incremental cost-effectiveness ratio (ICER) of 23,080/QALY compared to no vaccination. Vaccinating all ≥60-year-olds every three years resulted in the highest QALY gain, with an ACER of €39,918/QALY. Compared to the ≥75 and high-risk strategy, this approach had an ICER of €107,623/QALY, whereas the 75+ and high-risk strategy had an ICER of €61,987/QALY compared to the ≥75 strategy alone. Biennial strategies were associated with higher ACERs and were dominated in incremental comparisons.CONCLUSION: RSV vaccination for older adults in the Netherlands can be cost-effective, particularly when vaccinating every three years.

AB - OBJECTIVE: This study evaluates the cost-effectiveness of respiratory syncytial virus (RSV) vaccination for older adults in the Netherlands, aiming to identify the most effective vaccination strategy.METHODS: A static decision tree cost-effectiveness model was developed to compare no vaccination with various RSV vaccination strategies for Dutch adults over six RSV seasons. Strategies included vaccinating adults aged ≥60, ≥75, and ≥75 combined with high-risk individuals aged 60-74. Each was assessed with two- and three-year intervals. The model incorporated health outcomes and costs associated with RSV disease and vaccination from a societal perspective, with a lifetime horizon. Recent incidence data were used, and vaccine effectiveness was based on efficacy from a meta-analysis for outpatient settings and real-world effectiveness data for inpatient settings. A probabilistic sensitivity analysis was conducted, using a €50,000 per quality-adjusted life year (QALY) willingness-to-pay threshold.RESULTS: Vaccinating individuals aged ≥75 years and high-risk groups every three years could prevent approximately 19,000 general practitioner visits, 3300 hospitalizations (including 245 intensive care admissions), and 870 deaths in the first year. This strategy would avoid €29.5 million in healthcare costs and €6.3 million in productivity losses, gaining 2900 QALYs. It was cost-effective, with an average cost-effectiveness ratio (ACER) of €30,804/QALY. The most cost-effective strategy was vaccinating ≥75 year-olds every three years, with an incremental cost-effectiveness ratio (ICER) of 23,080/QALY compared to no vaccination. Vaccinating all ≥60-year-olds every three years resulted in the highest QALY gain, with an ACER of €39,918/QALY. Compared to the ≥75 and high-risk strategy, this approach had an ICER of €107,623/QALY, whereas the 75+ and high-risk strategy had an ICER of €61,987/QALY compared to the ≥75 strategy alone. Biennial strategies were associated with higher ACERs and were dominated in incremental comparisons.CONCLUSION: RSV vaccination for older adults in the Netherlands can be cost-effective, particularly when vaccinating every three years.

KW - Cost-effectiveness

KW - Older adults

KW - Rsv

KW - Vaccination strategy

KW - Quality-Adjusted Life Years

KW - Vaccination/economics

KW - Humans

KW - Middle Aged

KW - Male

KW - Vaccine Efficacy

KW - Respiratory Syncytial Virus Vaccines/economics

KW - Respiratory Syncytial Virus Infections/prevention & control

KW - Cost-Benefit Analysis

KW - Aged, 80 and over

KW - Female

KW - Aged

KW - Netherlands/epidemiology

U2 - 10.1016/j.vaccine.2025.127735

DO - 10.1016/j.vaccine.2025.127735

M3 - Article

C2 - 41015848

SN - 0264-410X

VL - 65

JO - Vaccine

JF - Vaccine

M1 - 127735

ER -

Evaluating cost-effectiveness of RSV vaccination strategies for older adults in the Netherlands

Abstract

Keywords

Access to Document

Fingerprint

Cite this