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# Scientific work

#### Health-Ecore publishes its methods and findings in peer-reviewed journals, public reports and conference contributions. Our work covers health technology assessment, cost-effectiveness and societal cost-benefit analysis, evidence synthesis and health policy.

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##### [![Adjuvanted Influenza Vaccine Cost Effectiveness Study-1](https://health-ecore.com/hubfs/AI-Generated%20Media/Images/Adjuvanted%20Influenza%20Vaccine%20Cost%20Effectiveness%20Study-1.png) Evaluating the cost-effectiveness of adjuvanted influenza vaccine in the older adult population in the Netherlands Replacing standard-dose with adjuvanted influenza vaccine for older adults proves cost-effective across a wide range of real-world effectiveness estimates in the Netherlands. A relevant finding as the national immunization programme weighs enhanced vaccine options for adults 60 and older. Article citation: de Braak S, Mould-Quevedo JF, Wilschut JC, et al. Evaluating the cost-effectiveness of adjuvanted influenza vaccine in the older adult population in the Netherlands. Hum Vaccin Immunother. 2026;22(1):2692245. doi:10.1080/21645515.2026.2692245    Vaccination Influenza Cost-Effectiveness Analysis](https://www.tandfonline.com/doi/full/10.1080/21645515.2026.2692245)

##### [![Influenza Vaccination CostEffectiveness Netherlands Adults 60-1](https://health-ecore.com/hubfs/AI-Generated%20Media/Images/Influenza%20Vaccination%20CostEffectiveness%20Netherlands%20Adults%2060-1.png) Cost-effectiveness of high-dose influenza vaccination in the Netherlands: Updated analysis incorporating new evidence High-dose influenza vaccination for adults 60 and older remains highly cost-effective in the Netherlands, even after incorporating new real-world evidence alongside trial data. A robust finding supporting implementation in the national immunization programme.  Article citation: van der Pol,S., Emamipour, S., van Oudheusden, A. et al. Cost-effectiveness of high-dose influenza vaccination in the Netherlands: Updated analysis incorporating new evidence, Vaccine X,31, 2590-1362, 2026, doi.org/10.1016/j.jvacx.2026.100857.   Vaccination Influenza Cost-Effectiveness Analysis](https://www.sciencedirect.com/science/article/pii/S259013622600080X?via%3Dihub)

##### [![NextGen Vaccine Impact in Netherlands-2-1](https://health-ecore.com/hubfs/AI-Generated%20Media/Images/NextGen%20Vaccine%20Impact%20in%20Netherlands-2-1.png) Potential Public Health and Economic Impact of the Next-Generation COVID-19 Vaccine mRNA-1283 in The Netherlands The next-generation COVID-19 vaccine mRNA-1283 could prevent thousands more hospitalizations than existing mRNA vaccines in the Netherlands, while remaining cost-effective at a modest price premium. A relevant finding as the national vaccination programme evaluates next-generation options for high-risk and older adults.  Article citation:  van der Pol S, Beck E, Westra T, Postma M, Boersma C. Potential Public Health and Economic Impact of the Next-Generation COVID-19 Vaccine mRNA-1283 in The Netherlands. Vaccines (Basel). 2026;14(4):364. Published 2026 Apr 20. doi:10.3390/vaccines14040364    COVID-19 Vaccination Cost-Effectiveness Analysis](https://www.mdpi.com/2076-393X/14/4/364)

##### [![Virtual Reality Therapy Postoperative Pain Netherlands-1](https://health-ecore.com/hubfs/AI-Generated%20Media/Images/Virtual%20Reality%20Therapy%20Postoperative%20Pain%20Netherlands-1.png) Early health economic analysis of virtual reality therapy for pain management after surgery Virtual reality therapy for postoperative pain only needs a modest reduction in opioid use at discharge to prove cost-effective in the Netherlands. This early health-economic analysis maps the evidence gaps still standing between VR therapy and routine postoperative care.   Article citation: Groenveld TD, van Dorst P, Ten Broek RPG, et al. Early health economic analysis of virtual reality therapy for pain management after surgery. Int J Surg. 2025;111(6):3798-3809. doi:10.1097/JS9.0000000000002385   VR therapy Pain management Early Health Economic Analysis](https://www.ovid.com/jnls/international-journal-of-surgery/fulltext/10.1097/js9.0000000000002385~early-health-economic-analysis-of-virtual-reality-therapy)

##### [![RSV Vaccination Strategy for Elderly Adults in Netherlands-1](https://health-ecore.com/hubfs/AI-Generated%20Media/Images/RSV%20Vaccination%20Strategy%20for%20Elderly%20Adults%20in%20Netherlands-1.png) Evaluating cost-effectiveness of RSV vaccination strategies for older adults in the Netherlands Vaccinating adults 75 and older against RSV every three years emerges as the most cost-effective strategy for the Netherlands, though targeting high-risk 60-74 year-olds alongside it prevents the most disease. A key comparison for shaping the national RSV immunization strategy for older adults. Article citation: Zeevat F, Luttjeboer J, Korsten K, et al. Evaluating cost-effectiveness of RSV vaccination strategies for older adults in the Netherlands. Vaccine. 2025;65:127735. doi:10.1016/j.vaccine.2025.127735    Vaccination RSV Cost-Effectiveness Analysis](https://www.sciencedirect.com/science/article/abs/pii/S0264410X25010321?via%3Dihub)

##### [![review human-1](https://health-ecore.com/hs-fs/hubfs/AI-Generated%20Media/Images/review%20human-1.png?width=1024&height=537&name=review%20human-1.png) The introduction and adoption of artificial intelligence in systematic literature reviews: a discrete choice experiment Researchers weigh AI adoption in systematic literature reviews on more than workload savings alone- sensitivity, proficiency requirements, and reviewer experience all shape whether a tool gets used. This discrete choice experiment offers a data-driven view into what actually drives AI adoption in evidence synthesis.  Article citation:  Abogunrin S, Slob BPH, Lane M, et al. The introduction and adoption of artificial intelligence in systematic literature reviews: a discrete choice experiment. BMJ Open. 2025;15(10):e099921. Published 2025 Oct 15. doi:10.1136/bmjopen-2025-099921     AI Systematic Literature Review Discrete Choice Experiment](https://bmjopen.bmj.com/content/15/10/e099921.long)

##### [![Cost Comparison of SMA Treatments in Netherlands-1-1](https://health-ecore.com/hs-fs/hubfs/AI-Generated%20Media/Images/Cost%20Comparison%20of%20SMA%20Treatments%20in%20Netherlands-1-1.png?width=1536&height=805&name=Cost%20Comparison%20of%20SMA%20Treatments%20in%20Netherlands-1-1.png) Cost comparison analysis of onasemnogene abeparvovec and nusinersen for treatment of patients with spinal muscular atrophy type 1 in the Netherlands One-time treatment with an upfront cost that provides a lifetime treatment effect for Spinal Muscular Atrophy (SMA) patients can save substantial healthcare costs when replacing a chronic lifelong treatment. Article citation: van der Schans, S., Velikanova, R., Weidlich, D. et al. Cost comparison analysis of onasemnogene abeparvovec and nusinersen for treatment of patients with spinal muscular atrophy type 1 in the Netherlands. Eur J Health Econ 26, 1101–1110 (2025). https://doi.org/10.1007/s10198-024-01754-3 SMA Medication Cost Comparison Analysis](https://link.springer.com/article/10.1007/s10198-024-01754-3)

##### [![Cost Effectiveness of Empagliflozin in Chronic Kidney Disease Patients-1](https://health-ecore.com/hs-fs/hubfs/AI-Generated%20Media/Images/Cost%20Effectiveness%20of%20Empagliflozin%20in%20Chronic%20Kidney%20Disease%20Patients-1.png?width=1536&height=805&name=Cost%20Effectiveness%20of%20Empagliflozin%20in%20Chronic%20Kidney%20Disease%20Patients-1.png) Cost effectiveness of empagliflozin in adult patients with chronic kidney disease in the Netherlands Empagliflozin added to standard care for chronic kidney disease is cost saving in the Netherlands, delivering more life years and quality-adjusted life years at a lower total cost. These findings support the guideline recommendation for empagliflozin use in CKD treatment.   Article citation:  Slob B, Fens T, Weersma M, Postma M, Boersma C, de Jong L (2024) Cost effectiveness of empagliflozin in adult patients with chronic kidney disease in the Netherlands. PLoS ONE 19(12): e0315509. https://doi.org/10.1371/journal.pone.0315509    CKD Medication Cost-Effectiveness Analysis](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0315509)

##### [![cdc-oGJQt3-X\_FY-unsplash-1-1](https://health-ecore.com/hs-fs/hubfs/Blog%20images/cdc-oGJQt3-X_FY-unsplash-1-1.jpeg?width=500&height=262&name=cdc-oGJQt3-X_FY-unsplash-1-1.jpeg) Cost-Effectiveness Analysis of Nirsevimab for Preventing Respiratory Syncytial Virus-Related Lower Respiratory Tract Disease in Dutch Infants: An Analysis Including All-Infant Protection The evidence base for preventing RSV keeps growing. Our analysis confirms nirsevimab can cost-effectively prevent RSV infections in Dutch infants.  Article citation: Zeevat F, van der Pol S, Kieffer A, Postma MJ, Boersma C. Cost-Effectiveness Analysis of Nirsevimab for Preventing Respiratory Syncytial Virus-Related Lower Respiratory Tract Disease in Dutch Infants: An Analysis Including All-Infant Protection. Pharmacoeconomics. 2025;43(5):569-582. doi:10.1007/s40273-025-01469-0      Vaccination RSV Cost-Effectiveness Analysis](https://link.springer.com/article/10.1007/s40273-025-01469-0)

##### [![CostEffectiveness Analysis of mRNA1273 vs BNT162b2 Vaccines in Netherlands-1-1](https://health-ecore.com/hubfs/AI-Generated%20Media/Images/CostEffectiveness%20Analysis%20of%20mRNA1273%20vs%20BNT162b2%20Vaccines%20in%20Netherlands-1-1.png) Cost-effectiveness Analysis of COVID-19 mRNA XBB.1.5 Fall 2023 Vaccination in the Netherlands The XBB1.5 updated mRNA-1273.222 vaccine offers substantial health and economic benefits with the right pricing. A critical consideration for future vaccination strategies. Article citation: Zeevat, F., van der Pol, S., Westra, T. et al. Cost-effectiveness Analysis of COVID-19 mRNA XBB.1.5 Fall 2023 Vaccination in the Netherlands. Adv Ther 42, 1550–1569 (2025). https://doi.org/10.1007/s12325-025-03112-y    COVID-19 Vaccination Cost-Effectiveness Analysis](https://link.springer.com/article/10.1007/s12325-025-03112-y)

##### [![Ealdery Vaccination with High Dose Influenza Shot-1-1](https://health-ecore.com/hs-fs/hubfs/AI-Generated%20Media/Images/Ealdery%20Vaccination%20with%20High%20Dose%20Influenza%20Shot-1-1.png?width=1536&height=805&name=Ealdery%20Vaccination%20with%20High%20Dose%20Influenza%20Shot-1-1.png) Cost-effectiveness of high-dose influenza vaccination in the Netherlands: Incorporating the impact on both respiratory and cardiovascular hospitalization Switching to high-dose flu vaccines for adults 60+ in the Netherlands is highly cost-effective. With strong public health impact and full cost-effectiveness at current pricing, HD-QIV is a smart upgrade to the national flu campaign. Article citation: van der Pol S, Zeevat F, Postma MJ, Boersma C. Cost-effectiveness of high-dose influenza vaccination in the Netherlands: Incorporating the impact on both respiratory and cardiovascular hospitalizations.Vaccine. 2024;42(15):3429-3436. doi:10.1016/j.vaccine.2024.04.040   Influenza Vaccination Cost-Effectiveness Analysis](https://www.sciencedirect.com/science/article/pii/S0264410X24004651?via%3Dihub)

##### [![Baloxavir Marboxil Influenza Economic Evaluation Netherlands-1-1](https://health-ecore.com/hs-fs/hubfs/AI-Generated%20Media/Images/Baloxavir%20Marboxil%20Influenza%20Economic%20Evaluation%20Netherlands-1-1.png?width=1536&height=805&name=Baloxavir%20Marboxil%20Influenza%20Economic%20Evaluation%20Netherlands-1-1.png) Antivirals to prepare for surges in influenza cases: an economic evaluation of baloxavir marboxil for the Netherlands Baloxavir marboxil emerges as a cost-effective treatment for seasonal influenza in the Netherlands, driven largely by shorter illness duration and productivity gains in the working population. A relevant finding for treatment strategy in high-risk and elderly patients. Article citation: van der Pol, S., Postma, M.J. & Boersma, C. Antivirals to prepare for surges in influenza cases: an economic evaluation of baloxavir marboxil for the Netherlands. Eur J Health Econ 25, 1557–1567 (2024). https://doi.org/10.1007/s10198-024-01683-1   Influenza Medication Cost-Effectiveness Analysis](https://link.springer.com/article/10.1007/s10198-024-01683-1)

##### [![Invasive Meningococcal Disease Caused by Neisseria Meningitidis Serogroup B-1](https://health-ecore.com/hs-fs/hubfs/AI-Generated%20Media/Images/Invasive%20Meningococcal%20Disease%20Caused%20by%20Neisseria%20Meningitidis%20Serogroup%20B-1.png?width=1693&height=887&name=Invasive%20Meningococcal%20Disease%20Caused%20by%20Neisseria%20Meningitidis%20Serogroup%20B-1.png) Cost of Illness Analysis of Invasive Meningococcal Disease Caused by Neisseria Meningitidis Serogroup B in the Netherlands—a Holistic Approach Meningococcal B disease strikes rarely but leaves a lasting economic footprint — long-term sequelae drive the majority of its costs in the Netherlands. This analysis quantifies the full societal burden, a critical input for evaluating MenB vaccination policy.  Article citation: Zeevat, F., Simons, J.J.M., Westra, T.A. et al. Cost of Illness Analysis of Invasive Meningococcal Disease Caused by Neisseria Meningitidis Serogroup B in the Netherlands—a Holistic Approach. Infect Dis Ther 13, 481–499 (2024). https://doi.org/10.1007/s40121-023-00903-0   Invasive Meningococcal Disease Cost of Illness Analysis Societal Burden](https://link.springer.com/article/10.1007/s40121-023-00903-0)

##### [![Patients Walking Outside Trombosis Centrum-1-1](https://health-ecore.com/hubfs/AI-Generated%20Media/Images/Patients%20Walking%20Outside%20Trombosis%20Centrum-1-1.png) Budget and Health Impact of Switching Eligible Patients with Atrial Fibrillation to Lower- Dose Dabigatran Switching eligible atrial fibrillation patients from reduced-dose apixaban or rivaroxaban to lower-dose dabigatran could reduce both clinical events and healthcare spending in the Netherlands. A budget impact finding with direct relevance for DOAC prescribing policy. Article citation: Fens T, de Jong L, Kappelhoff B, Boersma C, Postma MJ. Budget and Health Impact of Switching Eligible Patients with Atrial Fibrillation to Lower- Dose Dabigatran. Journal of Market Access & Health Policy. 2023; 11(1):2247719. https://doi.org/10.1080/20016689.2023.2247719   Medication DOAC Budget Impact Analysis](https://www.mdpi.com/2001-6689/11/1/2247719)

##### [![Cost Effectiveness of Empagliflozin in Heart Failure Patients Netherlands-1-1](https://health-ecore.com/hubfs/AI-Generated%20Media/Images/Cost%20Effectiveness%20of%20Empagliflozin%20in%20Heart%20Failure%20Patients%20Netherlands-1-1.png) Cost‐Effectiveness of Empagliflozin in Patients with Chronic Heart Failure Irrespective of Left‐Ventricle Ejection Fraction in the Netherlands Empagliflozin added to standard care is cost-effective across the full spectrum of chronic heart failure in the Netherlands, regardless of ejection fraction. A robust finding supporting broader empagliflozin use in HF treatment guidelines.  Article citation: Slob, B.P.H., Postma, M.J., Weersma, M. et al. Cost-Effectiveness of Empagliflozin in Patients with Chronic Heart Failure Irrespective of Left-Ventricle Ejection Fraction in the Netherlands. Am J Cardiovasc Drugs 25, 715–726 (2025). https://doi.org/10.1007/s40256-025-00749-6   Medication Chronic Heart Failure Cost-Effectiveness Analysis](https://link.springer.com/article/10.1007/s40256-025-00749-6)

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