Clinical and economic impact of herpes zoster vaccination in elderly in Italy

Abstract

Herpes zoster (HZ) is a very relevant pathology among elderly people ( 60 years of age), with a considerable disease burden and loss of quality of life. In the last years a new vaccine against HZ became available in Italy. Therefore, the Italian decision makers are now confronted with the decision whether that vaccination should be implemented. Pharmaco-economic analyses represent useful tools to value the feasibility of new immunization programs and their sustainability. To this aim, an ad hoc population model was developed in order to value the clinical and economic impact of HZ vaccination program for the elderly in Italy. Particularly, different immunization scenarios were modeled: vaccination of 60 years-old subjects (single cohort strategy), simultaneous vaccination of people aged 60 and 65 years (double cohort strategy) and, lastly, immunization of people aged 60, 65 and 70 years (triple cohort strategy), thus leading to the vaccination of 5, 10 and 15 cohorts during the first 5 years of the program. The mathematical model valued the clinical impact of vaccination on the number of HZ, postherpetic neuralgia (PHN) and ophthalmic HZ. The results of the analysis show that, in Italy, a cohortbased HZ vaccination program in elderly could have a relevant impact on the reduction of clinical cases and a favorable economic profile for the National Health Service (NHS), as already foreseen in other countries. In addition, further benefits could be obtained when extending the study period beyond the 5-year horizon of our analysis.

Measuring herpes zoster disease burden in São Paulo, Brazil: a clinico-epidemiological single-center study

“…Their use further carries the risk of recall bias, as prevalent cases were included in the study. Finally, despite the limited ability to conduct a comprehensive pharmacoeconomic analysis due to patients’ self-reporting their HZ-related costs, previous studies have shown the economic benefits of implementing a zoster vaccination program among the elderly 33 . Moreover, misclassification of outcomes may have been introduced in the analysis as the diagnosis of HZ was not confirmed by laboratory testing and solely relied on physicians’ assessments of the rash and patients’ reporting of pain.…”

Temporal trends in herpes zoster-related hospitalizations in Italy, 2001–2013: differences between regions that have or have not implemented varicella vaccination

“…Recently, an ad hoc population model has been developed to value the clinical and economic impact of HZ vaccination program for the elderly in Italy. The result show that the vaccination in elderly could have a relevant impact on the reduction of clinical cases and a favorable economic profile for the National Health Service (NHS) [48]. Immunization would reduce the overall health and social impact of this disease and would allow to improve the well-being of the population, of elderly in particular [49].…”

The potential public health impact of Herpes Zoster vaccination in the 65 years of age cohort in Italy

“…27 Recent analyses demonstrated the superior public health impact of RZV compared with ZVL in Germany and Japan, 28,29 as well as the cost-effectiveness of RZV in older adults in USA and Germany. 30,31 A previous study has shown that introducing a HZ vaccination program for older adults using ZVL would have a beneficial clinical and health economic impact in Italy, 32 while currently there is no such evidence for RZV in the Italian setting.…”