The Socioeconomic Value of Adult Respiratory Immunization Programs in France: Can Improved Coverage Unlock Missed Gains?
Author(s)
Matthew William Napier, MSc1, Stephane Fievez, PhD2, Simon Brassel, MSc1, yasmine fahfouhi, PharmD2, Claud Theakston, MSc1, marie mongazon-cazavet, MSc, PharmD2, Ayoub Boukhlal, PharmD2, Jingyan Yang, DrPH3, Jeffrey Vietri, BA, MS, PhD4, Diana Mendes, PhD5, Tianyan Hu, PhD3, Lotte Steuten, MSc, PhD1.
1Office of Health Economics, London, United Kingdom, 2Pfizer, Paris, France, 3Pfizer, New York, NY, USA, 4Pfizer, Collegeville, PA, USA, 5Pfizer, Tadworth, United Kingdom.
1Office of Health Economics, London, United Kingdom, 2Pfizer, Paris, France, 3Pfizer, New York, NY, USA, 4Pfizer, Collegeville, PA, USA, 5Pfizer, Tadworth, United Kingdom.
OBJECTIVES: In France, immunisation is recommended for older adults and individuals at increased risk of severe illness from pneumococcal disease, respiratory syncytial virus (RSV), influenza, and COVID-19. These programmes aim to reduce mortality, morbidity, and healthcare system burden. However, uptake remains low. We estimated the socioeconomic value of current coverage and foregone value due to suboptimal coverage, highlighting potential gains from improving adult immunisation against respiratory diseases.
METHODS: We developed four disease models to estimate fatal and non-fatal cases averted by each adult immunisation programme. Benefits were assessed using a Benefit-Cost Analysis framework, categorising monetised outcomes into: 1) reduced mortality, 2) reduced morbidity, and 3) reduced work productivity loss.
Mortality risk reduction was monetised using an age-independent Value of a Statistical Life (VSL) or, for age-dependent estimates, by applying a Value of a Statistical Life Year (VSLY) to remaining life expectancy. Morbidity was monetised using a cost-of-illness approach.
Benefit-cost ratios (BCRs) and net benefits (NBs) were calculated over all cohorts’ lifetimes by aggregating total benefits and costs. We compared outcomes under three scenarios: (1) age-based recommendations only, (2) addition of risk-based recommendations, (3) aspirational 75% coverage across all cohorts.
RESULTS: For each €1 invested, age-based recommendations return €17 when benefits are valued using the VSL, and €4 using the VSLY over the lifetime. This translates to NBs of €183.35 billion and €30.43 billion, respectively. Compared to the age-based recommendations, including at-risk groups raises NBs by 40.8% (VSL) and 60.1% (VSLY). Achieving aspirational coverage would increase NBs by €435.27 billion (237%, VSL) and €97.23 billion (319%, VSLY).
CONCLUSIONS: Adult respiratory vaccination programs offer substantial socioeconomic value through improved population health, reduced healthcare system burden, and increased productivity. In France, suboptimal coverage limits these benefits. Improving coverage among older adults and younger at-risk adults could generate significant societal gains.
METHODS: We developed four disease models to estimate fatal and non-fatal cases averted by each adult immunisation programme. Benefits were assessed using a Benefit-Cost Analysis framework, categorising monetised outcomes into: 1) reduced mortality, 2) reduced morbidity, and 3) reduced work productivity loss.
Mortality risk reduction was monetised using an age-independent Value of a Statistical Life (VSL) or, for age-dependent estimates, by applying a Value of a Statistical Life Year (VSLY) to remaining life expectancy. Morbidity was monetised using a cost-of-illness approach.
Benefit-cost ratios (BCRs) and net benefits (NBs) were calculated over all cohorts’ lifetimes by aggregating total benefits and costs. We compared outcomes under three scenarios: (1) age-based recommendations only, (2) addition of risk-based recommendations, (3) aspirational 75% coverage across all cohorts.
RESULTS: For each €1 invested, age-based recommendations return €17 when benefits are valued using the VSL, and €4 using the VSLY over the lifetime. This translates to NBs of €183.35 billion and €30.43 billion, respectively. Compared to the age-based recommendations, including at-risk groups raises NBs by 40.8% (VSL) and 60.1% (VSLY). Achieving aspirational coverage would increase NBs by €435.27 billion (237%, VSL) and €97.23 billion (319%, VSLY).
CONCLUSIONS: Adult respiratory vaccination programs offer substantial socioeconomic value through improved population health, reduced healthcare system burden, and increased productivity. In France, suboptimal coverage limits these benefits. Improving coverage among older adults and younger at-risk adults could generate significant societal gains.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE726
Topic
Economic Evaluation
Disease
Vaccines