New results from a study conducted by the Institute of Public Health at Rīga Stradiņš University (RSU IPH) provide compelling economic evidence that vaccination is not only an effective public health intervention but also a cost-effective long-term investment in Latvia’s healthcare system. Using health economics models explicitly developed for Latvia, RSU IPH researchers have demonstrated that three vaccination strategies simultaneously improve patient health outcomes and reduce the long-term financial burden of disease.
RSU IPH is the first scientific institution in Latvia to systematically develop health technology assessment (HTA) economic models tailored to the Latvian healthcare context. The research programme aims to support evidence-based decision-making in public health policy and to promote more rational allocation of state budget resources.
Taking a significant step toward more sustainable healthcare, within the national research programme “Public Health” project New Knowledge and Approaches to Reducing Antimicrobial Resistance, Limiting HIV, and Expanding Vaccination Coverage, RSU IPH developed health technology economic evaluation models in line with internationally recognised methodologies. Their goal is to improve patient health while 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 a patient’s lifetime. These models are based on patient pathway simulations that reflect the natural course of disease, treatment options, and possible outcomes, integrating data from multiple sources and applying mathematical and statistical methods.
"As patient needs and healthcare costs continue to grow, economic modelling is no longer optional; it is an integral part of informed decision-making. The models we have developed show how limited resources can be used as efficiently as possible while increasing health benefits for patients," explains Uldis Hļevickis, researcher at RSU IPH.
During the programme, the developed economic models were piloted to evaluate three preventive vaccines in Latvia: immunoprophylaxis against tick-borne encephalitis, respiratory syncytial virus (RSV) in preterm infants, and pneumococcal infection in seniors.
Key results indicate that vaccination against tick-borne encephalitis in the adult population provides additional health benefits while simultaneously reducing direct treatment costs. Calculations for a population of 100,000 show a reduction of 21,671 hospitalisations, 546 fewer intensive care cases, and 31 fewer cases requiring treatment for long-term neurological complications in the vaccinated group. According to Latvian observational data, the economic model estimated six deaths in the unvaccinated cohort, while no deaths occurred among vaccinated individuals.
The economic evaluation of immunisation against respiratory syncytial virus in preterm infants confirms cost-effectiveness, with an incremental cost-effectiveness ratio of €13,822.55 per additional quality-adjusted life year gained. The model predicts preventing 100 hospitalisations, 18 intensive care cases, and 118 cases requiring treatment for long-term complications per 1,000 infants, as well as preventing six deaths.
Meanwhile, the evaluation of the pneumococcal vaccine PCV20, a pneumococcal conjugate vaccine covering 20 S. pneumoniae serotypes, in people aged over 65 shows a reduction of 88 hospitalisations, two fewer intensive care cases, and 11 deaths prevented, alongside reduced direct treatment costs. Similar to the evaluation of vaccination against tick-borne encephalitis, the economic assessment of PCV20 demonstrates additional health gains at lower direct treatment costs.
"The results allow us to combine clinical evidence with financial reality," notes U. Hļevickis. "This provides a strong foundation for transparent, evidence-based decisions that improve patient access to services and strengthen the sustainability of the healthcare system."
The study results provide an essential 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 short-term budgetary impact, but primarily in terms of their long-term benefits to public health.
