Cost-effectiveness of vaccination against herpes zoster

Boer, Pieter T. de; Wilschut, Jan; Postma, Maarten J.

doi:10.4161/hv.28670

Cited by 17 publications

(15 citation statements)

References 63 publications

(369 reference statements)

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“…Other parameters impacting the ICER included the proportion of patients with HZ developing PHN, HZ incidence, vaccine price and QALY loss for HZ with PHN. These parameters were similar to those identified in cost-effectiveness studies of ZVL vaccination [ 37 , 38 ].…”

Section: Discussionsupporting

confidence: 73%

“…In another Japanese prospective cohort study, a PHN proportion of 9.2% was reported, approximately 50% lower than the base-case value [ 25 ]. Therefore, in one-way DSA, the age-specific PHN proportion was reduced by 50%, which represents the lower bound of values reported in cost-effectiveness analyses of herpes zoster vaccination [ 38 , 40 ]. The resulting ICER increased by almost 50%.…”

Section: Discussionmentioning

confidence: 99%

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Cost-Effectiveness of the Adjuvant Recombinant Zoster Vaccine in Japanese Adults Aged 65 Years and Older

Shiragami

Mizukami²,

Kaise³

et al. 2019

Dermatol Ther (Heidelb)

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Introduction The incidence of herpes zoster (HZ) rises steeply after the age of 50 years and the number of HZ cases and complications such as postherpetic neuralgia (PHN) is predicted to increase because of the ageing population. The objective of this study was to estimate the cost-effectiveness of recombinant zoster vaccine (RZV) compared with no vaccine for the Japanese population aged ≥ 65 years. Methods A multi-cohort static Markov model with a cycle length of 1 year was used to follow a hypothetical cohort of 1 million people aged ≥ 65 years over their remaining lifetime. Vaccination at ≥ 65 years was used in alignment with the influenza and pneumococcal vaccines recommended from 65 years. Japan-specific data inputs for the model were obtained from local data sources. Age-stratified vaccine efficacy and waning rates were based on published clinical trial data. In the base-case analysis, vaccine coverage was assumed to be 40% with a second dose compliance of 95%. Costs and outcomes were discounted at 2% annually and the incremental cost-effectiveness ratio (ICER) was calculated from both a payer’s and the societal perspective. Sensitivity analyses were carried out to explore the overall uncertainty in the model. Results Vaccination with RZV was projected to prevent 48,943 HZ cases and 12,136 PHN cases per million people aged ≥ 65 years compared with no vaccination. The incremental costs and quality-adjusted life years (QALYs) gained were ¥9.99 billion and 2314 QALYs from a payer’s perspective and ¥9.34 billion and 2314 QALYs from a societal perspective. The resulting ICERs were approximately ¥4,320,000 and ¥4,040,000 per QALY gained from a payer’s and the societal perspective, respectively. The ICER remained below a willingness-to-pay threshold of ¥5,000,000 for most sensitivity analyses carried out. Conclusion Vaccination against HZ with RZV would be cost-effective compared with no vaccination for the Japanese population aged ≥ 65 years. Trial Registration GSK study identifier: HO-16-17837. Funding GlaxoSmithKline Biologicals SA. Electronic supplementary material The online version of this article (10.1007/s13555-019-0291-4) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Cost-Effectiveness of the Adjuvant Recombinant Zoster Vaccine in Japanese Adults Aged 65 Years and Older

Shiragami

Mizukami²,

Kaise³

et al. 2019

Dermatol Ther (Heidelb)

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“…22 Furthermore, the results were in line with the conclusions drawn from 2 recent literature reviews [30][31][32] Methods…”

Section: Resultssupporting

confidence: 90%

Cost-effectiveness analysis of a vaccination program for the prevention of herpes zoster and post-herpetic neuralgia in adults aged 50 and over in Germany

Préaud

Uhart²,

Böhm³

et al. 2015

Human Vaccines & Immunotherapeutics

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Herpes zoster (HZ; shingles) is a common viral disease that affects the nerves and surrounding skin causing a painful dermatomal rash and leading to debilitating complications such as, mainly, post-herpetic neuralgia (PHN). Currently, there is no effective treatment for HZ and PHN. The objective of this study was to assess the cost-effectiveness of a HZ vaccination program in Germany. An existing Markov Model was adapted to the German healthcare setting to compare a vaccination policy to no vaccination on a lifetime time-horizon, considering 2 scenarios: vaccinating people starting at the age of 50 or at the age of 60 years, from the perspective of the statutory health insurance (SHI) and the societal perspective. According to the perspective, vaccinating 20% of the 60+ German population resulted in 162,713 to 186,732 HZ and 31,657 to 35,793 PHN cases avoided. Corresponding incremental cost-effectiveness ratios (ICER) were 39,306 €/QALY from the SHI perspective and 37,417 €/QALY from a societal perspective. Results for the 50+ German population ranged from 336,468 to 394,575 HZ and from 48,637 to 56,087 PHN cases avoided from the societal perspective. Corresponding ICER were 39,782 €/QALY from a SHI perspective and 32,848 €/QALY from a societal perspective. Sensitivity analyses showed that results are mainly impacted by discount rates, utility values and use of alternative epidemiological data.The model indicated that a HZ vaccination policy in Germany leads to significant public health benefits and could be a cost-effective intervention. The results were robust and consistent with local and international existing literature.

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“…[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Although the mathematical models and the assumptions are different, these studies demonstrate clearly that the HZ vaccination in the elderly population has a favorable economic profile. Vaccination could have a significant impact on HZ disease and, above all, results a very good investment for NHS and Society.…”

Section: Discussionmentioning

confidence: 95%

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

Boccalini

Alicino

Martinelli

et al. 2016

Human Vaccines & Immunotherapeutics

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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.

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Cost-effectiveness of vaccination against herpes zoster

Cited by 17 publications

References 63 publications

Cost-Effectiveness of the Adjuvant Recombinant Zoster Vaccine in Japanese Adults Aged 65 Years and Older

Cost-Effectiveness of the Adjuvant Recombinant Zoster Vaccine in Japanese Adults Aged 65 Years and Older

Cost-effectiveness analysis of a vaccination program for the prevention of herpes zoster and post-herpetic neuralgia in adults aged 50 and over in Germany

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

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