Please use this identifier to cite or link to this item:
http://hdl.handle.net/1942/36677
Title: | Cost-Effectiveness Analysis of Herpes Zoster Vaccination in 50- to 85-Year-Old Immunocompetent Belgian Cohorts: A Comparison between No Vaccination, the Adjuvanted Subunit Vaccine, and Live-Attenuated Vaccine | Authors: | PIETERS, Zoe OGUNJIMI, Benson Beutels, Philippe Bilcke, Joke |
Issue Date: | 2022 | Publisher: | ADIS INT LTD | Source: | PHARMACOECONOMICS, 40 (4) , p.461-476 | Abstract: | Background A new adjuvanted subunit vaccine (HZ/su), with higher vaccine efficacy than live-attenuated vaccine (ZVL), has been licensed in Europe since March 2018. Therefore, Belgian decision-makers might need to re-assess their recommendations for vaccination against herpes zoster (HZ). Methods We conducted a cost-effectiveness analysis, using a Markov decision tree, of vaccinating 50- to 85-year-old immunocompetent Belgian cohorts with no vaccination, HZ/su, ZVL, and ZVL with booster after 10 years. Due to the uncertainty in vaccine waning of HZ/su vaccine beyond 4 years, we used a logarithmic and 1-minus-exponential function to model respectively a long and short duration of protection. We used a lifetime time horizon and implemented the health care payer perspective throughout the analysis. Results HZ/su had the greatest impact in avoiding health and economic burden. However, it would never become cost-effective at a willingness-to-pay threshold of euro40,000 per quality-adjusted life year (QALY) gained at its market price set by the manufacturer in the USA. Depending on the waning function assumed for HZ/su, the price per dose needs to drop 60% or 83% such that vaccination with HZ/su, assuming respectively a long or short duration of protection, would become cost-effective in 50- and 80-year-old individuals. At euro40,000 per QALY gained, ZVL or ZVL with booster was never found cost-effective compared with HZ/su, even if only administration cost was considered. Conclusion HZ/su is cost-effective in the 50-year-old age cohort at the unofficial Belgian threshold of euro40,000 per QALY gained, if its price drops to euro55.40 per dose. This result is, however, very sensitive to the assumed duration of protection of the vaccine, and the assumed severity and QALY loss associated with HZ and post-herpetic neuralgia (PHN). | Notes: | Bilcke, J (corresponding author), Univ Antwerp, Ctr Hlth Econ Res & Modeling Infect Dis CHERMID, Vaccine & Infect Dis Inst VAXINFECTIO, Univ Pl 1, B-2610 Antwerp, Belgium. joke.bilcke@uantwerpen.be |
Document URI: | http://hdl.handle.net/1942/36677 | ISSN: | 1170-7690 | e-ISSN: | 1179-2027 | DOI: | 10.1007/s40273-021-01099-2 | ISI #: | WOS:000750643800001 | Rights: | The Author(s), under exclusive licence to Springer Nature Switzerland AG 2022 | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2023 |
Appears in Collections: | Research publications |
Files in This Item:
File | Description | Size | Format | |
---|---|---|---|---|
Pieters2022_Supplement.pdf | Peer-reviewed author version | 1.74 MB | Adobe PDF | View/Open |
Cost‑Effectiveness_Analysis_of.pdf Restricted Access | Published version | 2 MB | Adobe PDF | View/Open Request a copy |
WEB OF SCIENCETM
Citations
4
checked on Jul 7, 2024
Page view(s)
52
checked on Sep 6, 2022
Download(s)
4
checked on Sep 6, 2022
Google ScholarTM
Check
Altmetric
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.