Cost-Effectiveness of a Vaccine to Prevent Herpes Zoster and Postherpetic Neuralgia in Older Adults

Abstract

The cost-effectiveness of the varicella zoster vaccine varies substantially with patient age and often exceeds $100,000 per quality-adjusted life year saved. Age should be considered in vaccine recommendations.

Cost-effectiveness of vaccination against herpes zoster

“…32,33 Finally 14 cost-effectiveness studies of HZ vaccination remained and were systematically reviewed. [34][35][36][37][38][39][40][41][42][43][44][45][46][47] Main study characteristics Table 1 summarizes the main characteristics of the included studies ordered by publication date. Several studies did not mention all the main features reported in Table 1, such as time horizon, costing year, sensitivity analysis and funding.…”

“…Country and funding Of the 14 studies included, 9 were conducted in European countries (UK, Belgium, The Netherlands, Switzerland and France) [34][35][36][37][38][39][40][41][42][43][44][45][46][47] and 5 in non-European countries (US and Canada). [35][36][37][38][39] Six studies were funded by the pharmaceutical industry, 36,38,41,42,44,46 five studies by public resources 34,37,39,40,43,45 and two studies were performed without external funding.…”

“…[35][36][37][38][39] Six studies were funded by the pharmaceutical industry, 36,38,41,42,44,46 five studies by public resources 34,37,39,40,43,45 and two studies were performed without external funding. 35,47 Type of analysis All 14 studies used the incremental cost-effectiveness ratio (ICER) as primary outcome, in which costs are expressed as monetary units and effects as quality-adjusted life years (QALY) gained.…”

“…34 Model design and alternatives A total of 13 studies used a "traditional" decision analytic model to calculate the cost-effectiveness of vaccination against HZ. [34][35][36][37][38][39][40][41][42][43][44][45][46][47] Decision models which were predominantly used concern Cohort models and Markov models. One study used discrete event simulation (DES) modeling.…”

“…This provides the model with a 'memory function' because specific attributes can be assigned to individuals and might in specific situations provide a superior alternative over adding "tunnel states" into the Markov model to artificially create memory. Within the context of the 14 studies analyzed, a total of 9 different models were used 34,35,[37][38][39][40]42,45,47 as some authors adapted already available models. 36,41,43,44,46 As no country already implemented HZ vaccination in its national immunization program when the analysis was performed, all studies compared routine vaccination against HZ with no such vaccination.…”