Cost-Effectiveness of Herpes Zoster Vaccination: A Systematic Review

Chiyaka, Edward T.; Nghiem, Van T.; Zhang, Lu; Deshpande, Abhishek; Mullen, Patricia Dolan; Le, Phuc

doi:10.1007/s40273-018-0735-1

Cited by 31 publications

(24 citation statements)

References 57 publications

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“…Also, assumptions about vaccination coverage, age at vaccination, price of the vaccine, cost per case, time horizon and discount rate differ both among the studies in the review and compared to our study. Vaccination with the live herpes zoster vaccine was deemed cost-effective in several studies that were conducted before 2014 when the long-term follow-up study on the duration of vaccine effectiveness was published [ 61 – 63 ]. After 2014, studies instead apply a shorter duration, more in line with the duration applied in our study, which gave rise to less favourable cost-effectiveness estimates [ 64 – 66 ].…”

Section: Discussionmentioning

confidence: 99%

“…A systematic review of cost-effectiveness studies of herpes zoster vaccination from 2019 [ 63 ] state that 15 out of 25 studies found that the live attenuated vaccine was cost-effective in comparison to no vaccination, with a vaccine price that ranged between US$93 and US$236 per dose. In the like with the systematic review from 2015 [ 61 ], the ingoing studies varied greatly both among the studies and in comparison to our study, with regards to vaccination coverage, age at vaccination, waning rate of the vaccine, price of the vaccine, cost per case, time horizon, and discount rate and the included health states.…”

Section: Discussionmentioning

confidence: 99%

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Cost-effectiveness of varicella and herpes zoster vaccination in Sweden: An economic evaluation using a dynamic transmission model

et al. 2021

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Objectives Comprehensive cost-effectiveness analyses of introducing varicella and/or herpes zoster vaccination in the Swedish national vaccination programme. Design Cost-effectiveness analyses based on epidemiological results from a specifically developed transmission model. Setting National vaccination programme in Sweden, over an 85- or 20-year time horizon depending on the vaccination strategy. Participants Hypothetical cohorts of people aged 12 months and 65-years at baseline. Interventions Four alternative vaccination strategies; 1, not to vaccinate; 2, varicella vaccination with one dose of the live attenuated vaccine at age 12 months and a second dose at age 18 months; 3, herpes zoster vaccination with one dose of the live attenuated vaccine at 65 years of age; and 4, both vaccine against varicella and herpes zoster with the before-mentioned strategies. Main outcome measures Accumulated cost and quality-adjusted life years (QALY) for each strategy, and incremental cost-effectiveness ratios (ICER). Results It would be cost-effective to vaccinate against varicella (dominant), but not to vaccinate against herpes zoster (ICER of EUR 200,000), assuming a cost-effectiveness threshold of EUR 50,000 per QALY. The incremental analysis between varicella vaccination only and the combined programme results in a cost per gained QALY of almost EUR 1.6 million. Conclusions The results from this study are central components for policy-relevant decision-making, and suggest that it was cost-effective to introduce varicella vaccination in Sweden, whereas herpes zoster vaccination with the live attenuated vaccine for the elderly was not cost-effective–the health effects of the latter vaccination cannot be considered reasonable in relation to its costs. Future observational and surveillance studies are needed to make reasonable predictions on how boosting affects the herpes zoster incidence in the population, and thus the cost-effectiveness of a vaccination programme against varicella. Also, the link between herpes zoster and sequelae need to be studied in more detail to include it suitably in health economic evaluations.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of varicella and herpes zoster vaccination in Sweden: An economic evaluation using a dynamic transmission model

et al. 2021

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“…In immunocompromised individuals or individuals anticipating becoming immunodeficient, however, the second dose can be administered as early as 1 to 2 months after the initial dose. 24 Regarding RZV administration in patients previously vaccinated for HZ, a phase-III, multi-center trial on RZV vaccine immunogenicity in previous ZVL vaccines compared to non-ZVL vaccinated Lyophilized (reconstituted with AS01 B adjuvant) 13 Approval date by FDA 5/2006 (for >60 years old), 3/2011 (for 50-59 years old) 13 10/2017 (for >50 years old) 13 Vaccine schedule (U.S.) Previously in >60 years old via a single dose. No longer used in the United States as of 11/2020 14 Adults >50 years old in two-dose series (2-6 months apart); immediate use as booster in patients previously vaccinated with ZVL 15 Duration of protection 8 years (for reducing HZ incidence); 10 years (for reducing HZ burden of disease, e.g., pain and discomfort) 16 7 years (for reducing HZ incidence; 14 patients demonstrated sustained humoral and cell-mediated immune responses regardless of prior vaccination status; 25 moreover, no difference in adverse events was observed, suggesting that RZV can be safely used in patients previously vaccinated with ZVL.…”

Section: Vaccine Administration and Special Considerationsmentioning

confidence: 99%

Global herpes zoster incidence, burden of disease, and vaccine availability: a narrative review

Pan

Lee

Nambudiri

2022

Therapeutic Advances in Vaccines and Immunotherapy

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Herpes zoster (HZ) is a neurocutaneous disease that causes significant morbidity worldwide. The disease is caused by the reactivation of the varicella-zoster virus (VZV), which leads to the development of a painful, vesicular rash and can cause complications such as post-herpetic neuralgia and vision loss. Globally, the incidence of HZ is increasing, and it incurs billions in cost annually to the healthcare system and to society through loss of productivity. With the advent of effective vaccines such as the live attenuated vaccine, Zostavax®, in 2006, and more recently the adjuvant recombinant subunit vaccine, Shingrix®, in 2017, HZ has become a preventable disease. However, access to the vaccines remains mostly limited to countries with developed economies, such as the United States and Canada. Even among countries with developed economies that license the vaccine, few have implemented HZ vaccination into their national immunization schedules due to cost-effectiveness considerations. In this review, we discuss the currently available HZ vaccines, landscape of HZ vaccine guidelines, and economic burden of disease in countries with developed and developing economies, as well as barriers and considerations in HZ vaccine access on a global scale.

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“…Many studies have shown that vaccines against influenza [44,45], pneumococcus [46][47][48][49] and herpes zoster [50][51][52] are cost-effective when given to older adults in a range of settings [53]. Notwithstanding this, the corresponding global economic burden offset by these adult VPD vaccines has not been fully calculated.…”

Section: Economic Benefits Of Older Adult Immunizationmentioning

confidence: 99%

A global agenda for older adult immunization in the COVID-19 era: A roadmap for action

Privor-Dumm

Poland

Barratt

et al. 2021

Vaccine

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Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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Cost-Effectiveness of Herpes Zoster Vaccination: A Systematic Review

Cited by 31 publications

References 57 publications

Cost-effectiveness of varicella and herpes zoster vaccination in Sweden: An economic evaluation using a dynamic transmission model

Cost-effectiveness of varicella and herpes zoster vaccination in Sweden: An economic evaluation using a dynamic transmission model

Global herpes zoster incidence, burden of disease, and vaccine availability: a narrative review

A global agenda for older adult immunization in the COVID-19 era: A roadmap for action

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