Cost-Effectiveness of Herpes Zoster Vaccine for Persons Aged 50 Years

Annals of Internal Medicine
Phuc Le, Michael B Rothberg

Abstract

Each year, herpes zoster (HZ) affects 1 million U.S. adults, many of whom develop postherpetic neuralgia (PHN). Zoster vaccine is licensed for persons aged 50 years or older, but its cost-effectiveness for those aged 50 to 59 years is unknown. To estimate the cost-effectiveness of HZ vaccine versus no vaccination. Markov model. Medical literature. Adults aged 50 years. Lifetime. Societal. HZ vaccine. Number of HZ and PHN cases prevented and incremental cost per quality-adjusted life-year (QALY) saved. For every 1000 persons receiving the vaccine at age 50 years, 25 HZ cases and 1 PHN case could be prevented. The incremental cost-effectiveness ratio (ICER) for HZ vaccine versus no vaccine was $323 456 per QALY. In deterministic and scenario sensitivity analyses, the only variables that produced an ICER less than $100 000 per QALY were vaccine cost (at a value of $80) and the rate at which efficacy wanes. In probabilistic sensitivity analysis, the mean ICER was $500 754 per QALY (95% CI, $93 510 to $1 691 211 per QALY). At a willingness-to-pay threshold of $100 000 per QALY, the probability that vaccination would be cost-effective was 3%. Long-term effectiveness data for HZ vaccine are lacking for 50-year-old adults. Herpes zoste...Continue Reading

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Citations

Oct 28, 2018·PharmacoEconomics·Edward T ChiyakaPhuc Le
Feb 19, 2019·Annals of Internal Medicine·Stephen D Shafran
Sep 27, 2018·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·Kenneth E SchmaderDesmond Curran
Apr 1, 2019·Dermatology and Therapy·Makoto ShiragamiDaisuke Watanabe
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Oct 24, 2019·Aging Clinical and Experimental Research·Pierre-Olivier Lang, Richard Aspinall
Dec 8, 2016·Human Vaccines & Immunotherapeutics·Sara BoccaliniPaolo Bonanni
Oct 16, 2016·Journal of General Internal Medicine·Phuc Le, Michael B Rothberg
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Nov 7, 2018·JAMA Internal Medicine·Desmond CurranPhilip Buck
Nov 7, 2018·JAMA Internal Medicine·Phuc Le, Michael B Rothberg
Aug 22, 2018·Human Vaccines & Immunotherapeutics·Desirée Van OorschotDesmond Curran
Jun 30, 2019·Applied Health Economics and Health Policy·Ashleigh McGirrDesmond Curran
May 26, 2018·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Joke BilckePhilippe Beutels
May 25, 2021·EClinicalMedicine·Ethan D BorreGillian D Sanders

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