Institute of Public Health study confirms importance and cost-effectiveness of vaccination

New findings from a study conducted by the Rīga Stradiņš University (RSU) Institute of Public Health provide convincing economic evidence that vaccination is not only an effective public health promotion tool, but also a cost-effective long-term investment in Latvia’s healthcare system. Using health economic models developed in Latvia, researchers at the RSU Institute of Public Health have demonstrated that three vaccination strategies simultaneously improve patient health outcomes and reduce the long-term financial burden of disease.

The RSU Institute of Public Health is the first scientific institution in Latvia to systematically develop health technology economic evaluation models tailored to the Latvian healthcare context. The aim of the research programme is to support evidence-based decision-making in public health policy and a more rational allocation of state budget resources.

In taking a significant step towards more sustainable healthcare, health technology economic evaluation models were developed within the RSU Institute of Public Health national research programme Public Health project “New knowledge and approaches to reduce antimicrobial resistance, limit the spread of HIV and expand community vaccination coverage”, in accordance with internationally recognised methodologies. The aim of these models is to improve patient health while simultaneously optimising the use of limited financial resources.

Economic modelling in healthcare enables a structured assessment of the costs and health benefits of various interventions, including vaccines, over the course of a patient’s lifetime. These models are based on simulations of patient pathways that reflect the natural course of disease, treatment options, and possible outcomes, integrating data from multiple sources and applying mathematical and statistical methods.

With patient needs and healthcare costs on the rise, economic modelling is no longer optional, but rather an integral part of decision-making. The models we have developed show how limited resources can be used as effectively as possible while increasing health benefits for patients.

Uldis Hļevickis, Researcher at the RSU Institute of Public Health

The economic models developed during the programme were piloted to evaluate three preventive vaccines in Latvia: immunoprophylaxis against tick-borne encephalitis, respiratory syncytial virus in premature infants, and pneumococcal infection in older adults.

The main findings indicate that vaccination against tick-borne encephalitis in the adult population provides additional health benefits while reducing direct treatment costs. Calculations for a population of 100,000 show a reduction of 21,671 hospitalisations and 546 intensive care admissions in the vaccinated group, as well as a reduction of 31 cases of long-term neurological sequelae treatment in the vaccinated group. According to Latvian observational data, the economic model calculated six deaths in the cohort of unvaccinated patients, compared with none in the vaccinated group.

The economic evaluation of immunisation against respiratory syncytial virus in premature infants confirms its cost-effectiveness, with an average cost-effectiveness ratio of EUR 13,822.55 per additional quality-adjusted life year gained. The model predicts the prevention of 100 hospitalisations, 18 intensive care admissions, and 118 cases requiring treatment for long-term sequelae per 1,000 infants, as well as the prevention of six deaths.

In turn, an assessment of people over 65 years of age who received the pneumococcal conjugate vaccine PCV20 – which includes 20 S. pneumoniae serotypes – shows a reduction in hospitalisations by 88 cases, a reduction in intensive care cases by two cases, and 11 deaths prevented, while also reducing direct treatment costs. As with tick-borne encephalitis vaccination, the economic evaluation of PCV20 demonstrates additional health benefits at reduced direct treatment costs.

‘These findings allow us to combine clinical evidence with financial considerations,’ notes Hļevickis. ‘This provides a solid foundation for transparent, evidence-based decision-making, improving access to services for patients and strengthening the sustainability of the healthcare system.’

The results of the study provide an important basis for improving the national immunisation programme and developing policy recommendations. They confirm that investments in vaccination should be assessed not only in terms of their short-term budgetary impact, but primarily in terms of their long-term benefits to public health.