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Title: Cost-effectiveness of vaccination against herpes zoster in adults aged over 60 years in Belgium
Authors: Bilcke, Joke
Marais, Christiaan
Willem, Lander
HENS, Niel 
Beutels, Philippe
Issue Date: 2012
Source: VACCINE, 30 (3), p. 675-684
Abstract: Aim: To assess the cost-effectiveness of vaccinating all or subgroups of adults aged 60 to 85 years against herpes zoster. Methods: A deterministic compartmental static model was developed (in freeware R), in which cohorts can acquire herpes zoster according to their age in years. Surveys and database analyses were conducted to obtain as much as possible Belgian age-specific estimates for input parameters. Direct costs and Quality-Adjusted Life-Year (QALY) losses were estimated as a function of standardised Severity Of Illness (S01) scores (i.e. as a function of the duration and severity of herpes zoster disease). Results: Uncertainty about the average SOIscore for a person with herpes zoster, the duration of protection from the vaccine, and the population that can benefit from the vaccine, exerts a major impact on the results: under assumptions least in favour of vaccination, vaccination is not cost-effective ( i.e. incremental cost per QALY gained > (sic) 48,000 for all ages considered) at the expected vaccine price of 90 per dose. At the same price, but under assumptions most in favour of vaccination, vaccination is found to be costeffective (i.e. incremental cost per QALY gained < (sic) 5500 for all ages considered). Vaccination of age cohort 60 seems more cost-effective than vaccination of any older age cohort in Belgium. Discussion: If the vaccine price per dose drops to (sic) 45, HZ vaccination of adults aged 60-64 years is likely to be cost-effective in Belgium, even under assumptions least in favour of vaccination. Unlike previous studies, our analysis acknowledged major methodological and model uncertainties simultaneously and presented outcomes for 26 different target ages at which vaccination can be considered (ages 60-85). (C) 2011 Elsevier Ltd. All rights reserved.
Notes: [Bilcke, Joke; Marais, Christiaan; Ogunjimi, Benson; Willem, Lander; Hens, Niel; Beutels, Philippe] Univ Antwerp, CHERMID, Vaccine & Infect Dis Inst Vaxinfectio, B-2610 Antwerp, Belgium. [Hens, Niel] Hasselt Univ, Interuniv Inst Biostat & Stat Bioinformat I BioSt, B-3590 Diepenbeek, Belgium.
Keywords: Immunology; Research & Experimental Medicine;Shingles; Zona; Cost-utility; Uncertainty; Illness
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ISSN: 0264-410X
e-ISSN: 1873-2518
DOI: 10.1016/j.vaccine.2011.10.036
ISI #: 000301812300022
Category: A1
Type: Journal Contribution
Validations: ecoom 2013
Appears in Collections:Research publications

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