Cost-effectiveness of varicella vaccine against herpes zoster and post-herpetic neuralgia for elderly in Japan

Hoshi, Shu-ling; Kondo, Masahide; Okubo, Ichiro

doi:10.1016/j.vaccine.2017.04.046

Cited by 21 publications

(10 citation statements)

References 35 publications

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“…As no data are available for the use of VVL for prevention of HZ, it is assumed that VE and waning data for the ZVL can be applied to VVL without any modifications. A similar assumption was made in a recent cost-effectiveness analysis of HZ vaccination in Japan [ 19 ]. The efficacy of ZVL was assessed in two phase III clinical trials that included > 38,000 individuals aged ≥ 60 years (the Shingles prevention study [SPS] [ 28 ]) and 22,000 individuals aged 50–59 years (the Zoster Efficacy and Safety Trial [ZEST] [ 29 ]).…”

Section: Methodsmentioning

confidence: 85%

“…Japan was one of the first countries in the world to introduce varicella vaccination, but universal varicella vaccination with the Varicella Vaccine Live (VVL) was not recommended until October 2014. In March 2016, VVL was approved in Japan for the prevention of HZ in individuals aged ≥ 50 years as an extended use [ 19 ]. The titer of the VVL used for HZ prevention in Japan is similar to that of the ZVL licensed for HZ prevention elsewhere in the world.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Potential Public Health Impact of Herpes Zoster Vaccination of People Aged ≥ 50 Years in Japan: Results of a Markov Model Analysis

Watanabe

Mizukami

Holl

et al. 2018

Dermatol Ther (Heidelb)

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IntroductionThe aim of this study was to compare the public health impact of introducing two herpes zoster (HZ) vaccines into the vaccination programs for the Japanese population aged ≥ 50 years: a single-dose Varicella Vaccine Live (VVL) or a two-dose adjuvanted Recombinant Zoster Vaccine (RZV).MethodsA multi-cohort static Markov model was developed to follow age cohorts (50–59, 60–69, 70–79 and ≥ 80 years) over their remaining lifetime. Japan-specific data inputs for the model were obtained from Japanese 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% for both vaccines, and compliance with second-dose of the RZV vaccine was set to 95%.ResultsVaccination with RZV was projected to prevent approximately 3.3 million HZ cases, 692,000 cases of postherpetic neuralgia (PHN), and 281,000 cases of other complications, compared with the prevention of 0.8 million HZ cases, 216,000 PHN cases, and 57,000 other complications with vaccination with VVL. The number of individuals needed to vaccinate in order to prevent one HZ case ranged from 6 to 14 using RZV (depending on age and assumed second-dose compliance) and from 21 to 138 depending on age using VVL. By preventing a higher number of HZ cases and its complications, RZV vaccination led to fewer outpatient visits and hospitalizations than vaccination with VVL.ConclusionBoth vaccines had a positive public health impact compared to no vaccination, but due to its higher vaccine efficacy, RZV demonstrated a superior public health impact compared with VVL.FundingGlaxoSmithKline Biologicals SA.Electronic supplementary materialThe online version of this article (10.1007/s13555-018-0236-3) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

The Potential Public Health Impact of Herpes Zoster Vaccination of People Aged ≥ 50 Years in Japan: Results of a Markov Model Analysis

Watanabe

Mizukami

Holl

et al. 2018

Dermatol Ther (Heidelb)

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“…Recently, the cost-effectiveness of varicella vaccination as HZ protection in individuals aged ≥ 65 years has been reported [ 18 ]. This study suggested VVL to be cost-effective in Japanese adults aged ≥ 65 years.…”

Section: Discussionmentioning

confidence: 99%

“…In Germany, the Standing Committee on Vaccination (STIKO) has recently issued its recommendation for RZV vaccination in people with underlying diseases aged between 50 and 60 as well as a general recommendation for RZV vaccination in people aged ≥ 60 years [ 17 ]. In Japan, the already existing varicella vaccine live (VVL) was approved by the Ministry of Health, Labour and Welfare (MHLW) in March 2016 for extended use in adults aged ≥ 50 years for HZ prevention on the basis that its titre is comparable to ZVL [ 18 ].…”

Section: Introductionmentioning

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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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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“…Moreover, varicella-related hospitalization and mortality rates dramatically decreased by 75–88% and 88–97% after a single dose of vaccine, respectively [12]. Despite that varicella vaccine is recommended by the World Health Organization (WHO) and is available throughout the world, it has only been incorporated into the national immunization program for children in a small number of countries because it is relatively expensive for the developing regions [13].…”

Section: Introductionmentioning

confidence: 99%

Seroprevalence and molecular characteristics of varicella-zoster virus infection in Chinese children

Luan¹,

Shen²,

Qiu

et al. 2019

BMC Infect Dis

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Background Varicella-zoster virus (VZV) infection in children is an important public health problem in China. We performed the current study to explore the seroprevalence of VZV infection in Chinese children in order to provide more information for improvement of varicella vaccination in China. Methods Three thousand fourteen children were recruited from Chinese kindergarten students aged from four to six years. Anti-VZV IgG and IgM were assayed using enzyme-linked immunosorbent assay. Both ORF22 and ORF62 of VZV were amplified, sequenced, and analyzed by nested PCR. Results Among 3014 children, 43.9% of boys and 46.3% of girls were vaccinated with varicella vaccine, respectively. The seroprevalence of anti-VZV IgG was 54.4% in the children with varicella vaccination, which was significantly higher than those in unvaccinated children (49.2%) (χ 2 = 8.206, P = 0.004). Among of the vaccinated children, the detection rates of VZV IgG antibody increased with age, with 49.4, 50.9 and 58.9% in 4, 5 and 6-year groups, respectively (Trend χ 2 = 17.202, P = 0.002). However, there was no difference in anti-VZV IgG detection rates among those unvaccinated children in different age groups (Trend χ 2 = 8.681, P = 0.070). In addition, 13 boys and 13 girls were positive for anti-VZV IgM, respectively. Among of them, eight children (0.6%) have received varicella vaccination, which was similar to those in unvaccinated children (1.1%). However, only one ORF22 sequence was isolated from an unvaccinated 5-year boy. Compared to the reference VZV sequences, the nucleotide homology was estimated to be 99.7% with genotype J. Conclusions Our study indicated that about half of Chinese children aged four to six years have a high risk of VZV infection. It should be helpful for the evaluation on the necessity of varicella immunization in China.

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Cost-effectiveness of varicella vaccine against herpes zoster and post-herpetic neuralgia for elderly in Japan

Cited by 21 publications

References 35 publications

The Potential Public Health Impact of Herpes Zoster Vaccination of People Aged ≥ 50 Years in Japan: Results of a Markov Model Analysis

The Potential Public Health Impact of Herpes Zoster Vaccination of People Aged ≥ 50 Years in Japan: Results of a Markov Model Analysis

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

Seroprevalence and molecular characteristics of varicella-zoster virus infection in Chinese children

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