Cost-effectiveness of herpes zoster vaccines in the U.S.: A systematic review

Meredith, Neil R.; Armstrong, Edward P.

doi:10.1016/j.pmedr.2022.101923

Cited by 4 publications

(3 citation statements)

References 18 publications

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“…These findings are aligned with results from other ZONA model analyses that have predicted RZV to be cost effective versus no HZ vaccination in the United States (US) [ 19 ], Japan [ 22 , 26 ], and Germany [ 24 ]. Three recent reviews have examined the cost effectiveness of RZV [ 49 – 51 ]. A 2022 meta-analysis of 12 studies (from the US, Asia, Canada, and Europe) that compared RZV versus no HZ vaccination concluded that RZV was cost effective for people aged 60–79 years from a societal perspective, and for those aged 60–69 years from a third-party payer perspective [ 49 ].…”

Section: Discussionmentioning

confidence: 99%

“…A 2023 review of 18 studies (from the US, Europe, Asia, and Canada) reported that RZV vaccination was predicted to be cost effective in 15 of the 18 included studies [ 50 ]. A 2022 systematic review of seven US studies concluded that RZV was a cost-effective strategy but that second-dose compliance is important [ 51 ]. Recent research has shown that barriers to the completion of RZV two-dose regimens include out-of-pocket costs, insurance coverage, accessibility, and patient forgetfulness, while healthcare provider encouragement, reminders, and self-motivation can improve completion [ 52 ].…”

Section: Discussionmentioning

confidence: 99%

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Updated Public Health Impact and Cost Effectiveness of Recombinant Zoster Vaccine in Canadian Adults Aged 50 Years and Older

George,

Carrico,

Hicks

et al. 2024

PharmacoEconomics Open

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Objectives The aim of this study was to update previously estimated public health impact and cost effectiveness of recombinant zoster vaccine (RZV) for the prevention of herpes zoster (HZ) in Canadians aged ≥50 years using longer-term RZV efficacy and waning data and real-world coverage and completion. Methods A multicohort Markov model was used to conduct a cost-utility analysis comparing RZV with no HZ vaccination among Canadians aged ≥50 years. Real-world data were used for first-dose coverage (17.5%) and second-dose completion (65%). Vaccine efficacy and waning data were applied from up to 8-year follow-up from the ZOE-50 and ZOE-70 clinical trials. Incremental costs and benefits were calculated using a lifetime horizon from the healthcare payer (base case) and societal perspectives. A discount rate of 1.5% was applied to costs and quality-adjusted life-years (QALYs). Results The model estimated that RZV would prevent 303,835 HZ cases, 83,256 post-herpetic neuralgia (PHN) cases, 39,653 other complications, and 99 HZ-related deaths compared with no HZ vaccination. Incremental cost-effectiveness ratios (ICERs) were estimated to be $27,486 and $22,097 per QALY (2022 Canadian dollars [CAN$]) from the healthcare payer and societal perspectives, respectively. The base-case ICER was most sensitive to a lower percentage of initial HZ cases with PHN. Almost all probabilistic sensitivity analysis simulations (98.1%) resulted in ICERs

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Updated Public Health Impact and Cost Effectiveness of Recombinant Zoster Vaccine in Canadian Adults Aged 50 Years and Older

George,

Carrico,

Hicks

et al. 2024

PharmacoEconomics Open

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“…Two recent meta-analyses have shown that routine RZV vaccination for older adults has the potential to be cost-effective 30 and consistently dominant over routine ZVL vaccination. 31 …”

Section: Introductionmentioning

confidence: 99%

How large could the public health impact of introducing recombinant zoster vaccination for people aged ≥50 years in five Latin American countries be?

Han

Gómez²,

Veras

et al. 2023

Human Vaccines & Immunotherapeutics

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This study aimed to: (1) estimate the disease burden of herpes zoster (HZ) and (2) assess the potential public health impact of introducing adjuvanted recombinant zoster vaccine (RZV) compared with no vaccination in adults aged ≥50 years in Argentina, Brazil, Mexico, Chile, and Colombia using the ZOster ecoNomic Analysis (ZONA) static multicohort Markov model. The model followed individuals aged ≥50 years from administration of RZV over their remaining lifetime. Inputs were based, most often, on local data. First dose coverage was assumed to be 35%, with 75% second dose compliance. It was predicted that without RZV, there would be 23,558,675 HZ cases, 6,115,981 post-herpetic neuralgia (PHN) cases, and 7,058,779 non-PHN complications in the five countries, but introducing RZV under assumed coverage could avoid 4,583,787 (19%) HZ cases, 1,130,751 (18%) PHN cases, and 1,373,419 (19%) non-PHN complications. Also, 10427,504 (20%) doctor’s office visits and 1,630,201 (19%) days of hospitalization could be averted in the three countries (Argentina, Brazil, and Mexico) with available input data. The numbers needed to be vaccinated to avoid one case of HZ were 9–10 across countries, and to avoid one case of PHN, 35–40. One-way sensitivity analyses showed that the input parameters with the largest impact on the estimated number of HZ cases avoided were first dose coverage, initial HZ incidence, and vaccine efficacy waning. In conclusion, the introduction of RZV for older adults in Latin America could greatly reduce the public health burden of HZ and reduce the related doctor visits and hospitalization days.

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Differential Utility Losses in Herpes Zoster Cases Between Vaccinated and Unvaccinated Subjects: A Meta-analysis of Three Clinical Trials

Giannelos,

Francq,

Curran

2024

Clin Drug Investig

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Background and Objective Recombinant zoster vaccine (RZV) is approved in adults for the prevention of herpes zoster. The effect of RZV in moderating the severity of breakthrough cases of herpes zoster has been noted but not explicitly quantified before. In this study, a meta-analysis was undertaken to estimate differential utility losses between unvaccinated (Placebo) and vaccinated (RZV) subjects in breakthrough cases of herpes zoster from three RZV clinical trials. Methods Differential utility losses between the two groups were estimated in units of quality-adjusted life-years (QALYs), leveraging aggregate patient data from the ZOE-50 (NCT01165177), ZOE-70 (NCT01165229), and ZOE-HSCT (NCT01610414) clinical trials. Differential utility losses and the ratio of mean utility losses were analyzed using random-effects and fixed-effects meta-regression models. Results The mean QALY loss differences between the unvaccinated (Placebo) and vaccinated (RZV) groups were 0.008, 0.004, and 0.011 in the ZOE-50, ZOE-70, and ZOE-HSCT studies, respectively, yielding an overall estimated difference of 0.007 (95% confidence interval 0.002–0.012) QALYs. Quality-adjusted life-year loss in the vaccinated group was estimated to be 35.5% of the value in the placebo group. A sensitivity analysis estimated an overall difference of 0.005 (95% confidence interval 0.001–0.009) QALYs, corresponding to 48.6% of the QALY loss value in the placebo group. Conclusions Recombinant zoster vaccine is effective in alleviating disease severity in breakthrough cases of herpes zoster. The results may be useful in distinguishing QALY losses between vaccinated and unvaccinated cohorts in health economics studies, particularly cost-effectiveness analyses. Supplementary Information The online version contains supplementary material available at 10.1007/s40261-024-01355-1.

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Cost-effectiveness of herpes zoster vaccines in the U.S.: A systematic review

Cited by 4 publications

References 18 publications

Updated Public Health Impact and Cost Effectiveness of Recombinant Zoster Vaccine in Canadian Adults Aged 50 Years and Older

Updated Public Health Impact and Cost Effectiveness of Recombinant Zoster Vaccine in Canadian Adults Aged 50 Years and Older

How large could the public health impact of introducing recombinant zoster vaccination for people aged ≥50 years in five Latin American countries be?

Differential Utility Losses in Herpes Zoster Cases Between Vaccinated and Unvaccinated Subjects: A Meta-analysis of Three Clinical Trials

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