Economic burden estimation to inform prevention policies against emerging zoonotic diseases: The case of tick-borne encephalitis in France.

[en] OBJECTIVES: Economic evidence on health losses can guide prioritisation of prevention policies for emerging zoonotic risks. Tick-borne encephalitis (TBE) is gaining attention in Western Europe, and notifications are rising in France. Our goal is to scope existing European burden estimates and to generate the first national figures for France using a standardized framework that can inform health policies.
STUDY DESIGN: This study was designed as a nationwide model-based cost-of-illness analysis combining a systematic literature review with a decision-tree simulation to estimate the costs of TBE in France.
METHODS: The systematic scoping review (2000-2025) identified studies reporting TBE costs. Our original estimate for France relied on the BCoDE (Burden of Communicable Disease in Europe) model (European Centre for Disease Prevention and Control, ECDC) to simulate health states and lost DALYs (disability-adjusted life years) due to infections in France (2024). Direct medical costs, indirect productivity losses, and intangible welfare losses were included. Sensitivity analyses explored ranges for uncertain parameters.
RESULTS: In France, total direct costs amounted to €2,021,701 and indirect costs to €289,550, averaging €11,112 per case. TBE caused about 43 lost DALYs, which translated into €33,229 per case. The annual burden was €9.22 million, with 75% intangible, 22% direct, and 3% indirect. Although aggregate burden remains low, per-case welfare losses are high.
CONCLUSIONS: Our findings provide the first quantitative TBE burden estimation for prevention planning in France. They support targeted vaccination and strengthened surveillance in emerging areas.