OBJECTIVES: Since the initiation of free seasonal influenza vaccination program in Beijing in 2007, the uptake rate remains low among older adults: 42% on average between 2008 and 2011. This research aimed to assess the cost-effectiveness of doubling the influenza vaccination coverage in adults aged 60 years and older under the free flu vaccination program in Beijing. METHODS: An analytical decision model of one influenza season was developed for adults aged 60 years and over in China. Demographic data were extracted from Beijing Municipal Bureau of Public Security and provincial census. Vaccine efficacies and utility weights were extracted from published literature. Costs were evaluated from healthcare payer perspective. Healthcare resource costs from published Chinese studies were inflated to cost year 2014. Deterministic sensitivity analyses were conducted. RESULTS: Doubling the coverage to 80% was predicted to avoid 69,517 influenza cases, 9,420 hospitalizations and 309 influenza-related deaths over one season in Beijing. Additional vaccination costs, estimated at 81 million RMB, would be partly offset by savings attributable to influenza cases avoided, estimated at 18 million RMB. The estimated number of quality-adjusted life-years (QALYs) gained was 2,812. As a result, the incremental cost-effectiveness ratio of the higher vaccination coverage rate was 22,735 RMB/QALY gained from healthcare payer perspective. Sensitivity analyses confirmed the robustness of the results and identified cost of influenza vaccines, influenza-like illness rate, and death rate as the key cost-effectiveness drivers. CONCLUSIONS: Improving seasonal influenza vaccination coverage among adults 60 years and older under the free influenza vaccination program in Beijing would substantially reduce influenza-related morbidity and mortality and was found to be cost-effective (< 1x GDP per capita). This suggests that additional funding to increase vaccination coverage, through financial incentives to doctors or advertisement to increase public awareness for example, should be considered.