PREVENTION PAYS OFF: ADULT RESPIRATORY IMMUNISATION AND THE ROAD TO UNIVERSAL HEALTH COVERAGE IN SOUTH AFRICA
Author(s)
Ellie Tunnicliffe, MSc1, Matthew Napier, MSc1, Angus Macfarlane, MSc1, Claud Theakston, MSc1, Simon Brassel, BSc, MSc1, Diana Mendes, PhD2, Carlos Fernando Mendoza, PhD3, Liping Huang, MSc4, Siphephisiwe Ndwandwe, MSc5, Phikolomzi Mgandela, BSc5, Tianyan Hu, PhD6, Lotte Steuten, MSc, PhD1.
1Office of Health Economics, London, United Kingdom, 2Pfizer Ltd., Tadworth, United Kingdom, 3Pfizer, Mexico City, Mexico, 4Pfizer, Washington Crossing, PA, USA, 5Pfizer, Johannesburg, South Africa, 6Pfizer, New York, NY, USA.
1Office of Health Economics, London, United Kingdom, 2Pfizer Ltd., Tadworth, United Kingdom, 3Pfizer, Mexico City, Mexico, 4Pfizer, Washington Crossing, PA, USA, 5Pfizer, Johannesburg, South Africa, 6Pfizer, New York, NY, USA.
OBJECTIVES: Respiratory illnesses from pneumococcal disease (PD), respiratory syncytial virus (RSV), seasonal influenza, and COVID-19 impose substantial socioeconomic burdens in South Africa. Adult immunisation remains limited and unevenly distributed across a two-tier health system; a publicly funded sector serves most of the population while fragmented private medical schemes cover a minority in relation to vaccine reimbursement. These lead to extremely low uptake rates relative to international comparators and benchmarks. As South Africa advances towards universal health coverage (UHC) under national health insurance, this study quantifies the broader societal value of delivering adult respiratory immunisation universally and at an aspirational uptake.
METHODS: Four static, deterministic disease models estimated fatal and non-fatal cases prevented by each programme across eligible adult age and risk groups, compared with no vaccination, separately for the public and private markets. Benefits followed an established Benefit-Cost Analysis framework categorising monetised outcomes into (1) mortality risk reduction, (2) morbidity risk reduction, and (3) productivity effects. Mortality risk reduction was valued either age-independently or age-adjusted using the value of a statistical life or life-year (VSL/VSLY). Morbidity risk reduction was quantified using cost-of-illness. Costs and outcomes were discounted at 5% (South African HTA Methods Guide). Benefit-Cost Ratios (BCRs) and net benefits (NBs) were aggregated across cohorts and programmes. This abstract reports the aspirational scenario: UHC-level population access with aspirational (75%) vaccine uptake.
RESULTS: Under UHC and aspirational uptake, the mean lifetime societal return on age-based adult respiratory immunisation ranged from 10:1 to 3:1, depending on whether VSLY or VSL was used to monetise mortality risk reduction, corresponding to estimated NBs of ZAR 32 billion (VSLY) and ZAR 170 billion (VSL).
CONCLUSIONS: Adult respiratory immunisation delivers substantial societal benefits relative to investment in South Africa. Reaching aspirational uptake rates under UHC could generate substantial societal welfare gains across both publicly funded and privately insured populations.
METHODS: Four static, deterministic disease models estimated fatal and non-fatal cases prevented by each programme across eligible adult age and risk groups, compared with no vaccination, separately for the public and private markets. Benefits followed an established Benefit-Cost Analysis framework categorising monetised outcomes into (1) mortality risk reduction, (2) morbidity risk reduction, and (3) productivity effects. Mortality risk reduction was valued either age-independently or age-adjusted using the value of a statistical life or life-year (VSL/VSLY). Morbidity risk reduction was quantified using cost-of-illness. Costs and outcomes were discounted at 5% (South African HTA Methods Guide). Benefit-Cost Ratios (BCRs) and net benefits (NBs) were aggregated across cohorts and programmes. This abstract reports the aspirational scenario: UHC-level population access with aspirational (75%) vaccine uptake.
RESULTS: Under UHC and aspirational uptake, the mean lifetime societal return on age-based adult respiratory immunisation ranged from 10:1 to 3:1, depending on whether VSLY or VSL was used to monetise mortality risk reduction, corresponding to estimated NBs of ZAR 32 billion (VSLY) and ZAR 170 billion (VSL).
CONCLUSIONS: Adult respiratory immunisation delivers substantial societal benefits relative to investment in South Africa. Reaching aspirational uptake rates under UHC could generate substantial societal welfare gains across both publicly funded and privately insured populations.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE285
Topic
Economic Evaluation, Epidemiology & Public Health, Study Approaches
Topic Subcategory
Work & Home Productivity - Indirect Costs
Disease
Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory), Vaccines