Timing Matters: Missed Opportunity to Prevent RSV Cases in Older Adults in Germany: A Markov Model Analysis
Author(s)
Severin Freisberg, MD1, Caroline Lade, PhD1, Josephine Friedrich, MSc2, Julia Schiffner-Rohe, Msc1, Christof von Eiff, MD2.
1Pfizer Pharma GmbH, Berlin, Germany, 2Pfizer, Berlin, Germany.
1Pfizer Pharma GmbH, Berlin, Germany, 2Pfizer, Berlin, Germany.
OBJECTIVES: Following regulatory approval, STIKO recommendation is the prerequisite for public reimbursement in Germany. However, implementation depends on regional agreements between physicians and sickness funds: Prices for vaccine application must be negotiated within each of the 17 regions in Germany. Therefore, regional agreements are key for full access to vaccines in Germany. However, delays in regional implementation of up to one year between STIKO recommendation and practical access have been observed. This study aims to quantify the consequences of delayed implementation. As a case example, we use RSV vaccines recommended for older adults in Germany.
METHODS: A validated Markov model was applied to the German population with German epidemiological and cost data, a one-year time horizon and a 0% discount rate. Seasonal infection patterns and regional implementation agreements were considered. The first possible start of vaccination was October 2024 reflecting the STIKO recommendation in August. The simulation compared scenarios of immediate access to recommended vaccinations versus delayed access, as observed for RSV vaccination in Germany (0-9 months). On average, the delay for the German population was 105 days. For the vaccination uptake, we assumed 50%-100% of the flu-vaccination uptake.
RESULTS: The simulation revealed a substantial number of avoidable RSV cases and deaths during the October to June period. Specifically, 16,500-25,000 cases (including 7,500-11,500 inpatient and 9,000-13,500 outpatient cases) and 600-900 deaths could have been prevented with timely access to vaccination, assuming 50%-100% of flu-uptake rates, respectively. This corresponds to a significant 36% of all cases that remained unprevented due to delayed implementation. If the maximal possible delay was reduced from nine months to three or even two months, this proportion would drop to 10.5% or 2.7%, respectively.
CONCLUSIONS: The findings highlight the serious patient impact of delayed vaccine implementation and the need to accelerate access to STIKO recommended vaccinations.
METHODS: A validated Markov model was applied to the German population with German epidemiological and cost data, a one-year time horizon and a 0% discount rate. Seasonal infection patterns and regional implementation agreements were considered. The first possible start of vaccination was October 2024 reflecting the STIKO recommendation in August. The simulation compared scenarios of immediate access to recommended vaccinations versus delayed access, as observed for RSV vaccination in Germany (0-9 months). On average, the delay for the German population was 105 days. For the vaccination uptake, we assumed 50%-100% of the flu-vaccination uptake.
RESULTS: The simulation revealed a substantial number of avoidable RSV cases and deaths during the October to June period. Specifically, 16,500-25,000 cases (including 7,500-11,500 inpatient and 9,000-13,500 outpatient cases) and 600-900 deaths could have been prevented with timely access to vaccination, assuming 50%-100% of flu-uptake rates, respectively. This corresponds to a significant 36% of all cases that remained unprevented due to delayed implementation. If the maximal possible delay was reduced from nine months to three or even two months, this proportion would drop to 10.5% or 2.7%, respectively.
CONCLUSIONS: The findings highlight the serious patient impact of delayed vaccine implementation and the need to accelerate access to STIKO recommended vaccinations.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HPR219
Topic
Health Policy & Regulatory
Topic Subcategory
Reimbursement & Access Policy
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Vaccines