Each year, around 300,000 Herpes Zoster (HZ) infections are reported in the German population, costing society more than €182 million. For this study, researchers wanted to quantify the potential public health and economic effect of the novel Adjuvanted Recombinant Zoster Vaccine (RZV, Shingrix) in the German population ≥ 60 years of age (YOA), as well as to determine the best age of immunization. We employed a static, multi-cohort Markov model with German-specific inputs to track a hypothetical cohort of 1 million persons ≥ 60 YOA following immunization. Costs and outcomes were both discounted at 3%, and the incremental cost-effectiveness ratio (ICER) was computed from a societal standpoint. The coverage of RZV was set at 40% with second-dose compliance of 70%. Vaccinating the population aged ≥ 60 YOA would result in 45,000 HZ cases avoided, 1,713 quality-adjusted life years (QALYs) gained at a total cost of approximately €63 million compared to 38,000 cases avoided, 1,545 QALYs gained at a total cost of approximately €68 million in the population ≥ 70 YOA. It would result in an ICER of approximately €37,000 and €44,000/QALY, for the age cohort ≥ 60 and ≥ 70 YOA, respectively. Scenario analyses demonstrated that vaccinating at age 60 or 65 YOA would show greater public health impact and would result in the lowest observed ICER compared to vaccinating at 70 YOA. In conclusion, starting vaccination with RZV in the German population ≥ 60 YOA would demonstrate the best value from public health and economic standpoint.
Reference:www.tandfonline.com/doi/full/10.1080/21645515.2018.1509645
