Cost-Effectiveness of the Adjuvant Recombinant Zoster Vaccine in Japanese Adults Aged 65 Years and Older

Abstract Introduction The incidence of herpes zoster (HZ) rises steeply after the age of 50 years and the number of HZ cases and complications such as postherpetic neuralgia (PHN) is predicted to increase because of the ageing population. The objective of this study was to estimate the cost-effectiv...

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Main Authors: Makoto Shiragami, Akiko Mizukami, Toshihiko Kaise, Desmond Curran, Desiree Van Oorschot, Benjamin Bracke, Daisuke Watanabe
Format: Article
Language:English
Published: Adis, Springer Healthcare 2019-03-01
Series:Dermatology and Therapy
Subjects:
Online Access:http://link.springer.com/article/10.1007/s13555-019-0291-4
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author Makoto Shiragami
Akiko Mizukami
Toshihiko Kaise
Desmond Curran
Desiree Van Oorschot
Benjamin Bracke
Daisuke Watanabe
author_facet Makoto Shiragami
Akiko Mizukami
Toshihiko Kaise
Desmond Curran
Desiree Van Oorschot
Benjamin Bracke
Daisuke Watanabe
author_sort Makoto Shiragami
collection DOAJ
description Abstract Introduction The incidence of herpes zoster (HZ) rises steeply after the age of 50 years and the number of HZ cases and complications such as postherpetic neuralgia (PHN) is predicted to increase because of the ageing population. The objective of this study was to estimate the cost-effectiveness of recombinant zoster vaccine (RZV) compared with no vaccine for the Japanese population aged ≥ 65 years. Methods A multi-cohort static Markov model with a cycle length of 1 year was used to follow a hypothetical cohort of 1 million people aged ≥ 65 years over their remaining lifetime. Vaccination at ≥ 65 years was used in alignment with the influenza and pneumococcal vaccines recommended from 65 years. Japan-specific data inputs for the model were obtained from local data sources. Age-stratified vaccine efficacy and waning rates were based on published clinical trial data. In the base-case analysis, vaccine coverage was assumed to be 40% with a second dose compliance of 95%. Costs and outcomes were discounted at 2% annually and the incremental cost-effectiveness ratio (ICER) was calculated from both a payer’s and the societal perspective. Sensitivity analyses were carried out to explore the overall uncertainty in the model. Results Vaccination with RZV was projected to prevent 48,943 HZ cases and 12,136 PHN cases per million people aged ≥ 65 years compared with no vaccination. The incremental costs and quality-adjusted life years (QALYs) gained were ¥9.99 billion and 2314 QALYs from a payer’s perspective and ¥9.34 billion and 2314 QALYs from a societal perspective. The resulting ICERs were approximately ¥4,320,000 and ¥4,040,000 per QALY gained from a payer’s and the societal perspective, respectively. The ICER remained below a willingness-to-pay threshold of ¥5,000,000 for most sensitivity analyses carried out. Conclusion Vaccination against HZ with RZV would be cost-effective compared with no vaccination for the Japanese population aged ≥ 65 years. Trial Registration GSK study identifier: HO-16-17837. Funding GlaxoSmithKline Biologicals SA.
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spelling doaj.art-3958e43289bb4c568abb57c6bcb319ea2022-12-21T19:49:32ZengAdis, Springer HealthcareDermatology and Therapy2193-82102190-91722019-03-019228129710.1007/s13555-019-0291-4Cost-Effectiveness of the Adjuvant Recombinant Zoster Vaccine in Japanese Adults Aged 65 Years and OlderMakoto Shiragami0Akiko Mizukami1Toshihiko Kaise2Desmond Curran3Desiree Van Oorschot4Benjamin Bracke5Daisuke Watanabe6Faculty of Pharmaceutical Sciences, Teikyo Heisei UniversityHealthoutcomes Department, GSKHealthoutcomes Department, GSKValue Evidence Department, GSKValue Evidence Department, GSKValue Evidence Department, GSKDepartment of Dermatology, Aichi Medical UniversityAbstract Introduction The incidence of herpes zoster (HZ) rises steeply after the age of 50 years and the number of HZ cases and complications such as postherpetic neuralgia (PHN) is predicted to increase because of the ageing population. The objective of this study was to estimate the cost-effectiveness of recombinant zoster vaccine (RZV) compared with no vaccine for the Japanese population aged ≥ 65 years. Methods A multi-cohort static Markov model with a cycle length of 1 year was used to follow a hypothetical cohort of 1 million people aged ≥ 65 years over their remaining lifetime. Vaccination at ≥ 65 years was used in alignment with the influenza and pneumococcal vaccines recommended from 65 years. Japan-specific data inputs for the model were obtained from local data sources. Age-stratified vaccine efficacy and waning rates were based on published clinical trial data. In the base-case analysis, vaccine coverage was assumed to be 40% with a second dose compliance of 95%. Costs and outcomes were discounted at 2% annually and the incremental cost-effectiveness ratio (ICER) was calculated from both a payer’s and the societal perspective. Sensitivity analyses were carried out to explore the overall uncertainty in the model. Results Vaccination with RZV was projected to prevent 48,943 HZ cases and 12,136 PHN cases per million people aged ≥ 65 years compared with no vaccination. The incremental costs and quality-adjusted life years (QALYs) gained were ¥9.99 billion and 2314 QALYs from a payer’s perspective and ¥9.34 billion and 2314 QALYs from a societal perspective. The resulting ICERs were approximately ¥4,320,000 and ¥4,040,000 per QALY gained from a payer’s and the societal perspective, respectively. The ICER remained below a willingness-to-pay threshold of ¥5,000,000 for most sensitivity analyses carried out. Conclusion Vaccination against HZ with RZV would be cost-effective compared with no vaccination for the Japanese population aged ≥ 65 years. Trial Registration GSK study identifier: HO-16-17837. Funding GlaxoSmithKline Biologicals SA.http://link.springer.com/article/10.1007/s13555-019-0291-4Cost-effectivenessHerpes zosterIncremental cost-effectiveness ratioMarkov modelPostherpetic neuralgiaQuality-adjusted life years
spellingShingle Makoto Shiragami
Akiko Mizukami
Toshihiko Kaise
Desmond Curran
Desiree Van Oorschot
Benjamin Bracke
Daisuke Watanabe
Cost-Effectiveness of the Adjuvant Recombinant Zoster Vaccine in Japanese Adults Aged 65 Years and Older
Dermatology and Therapy
Cost-effectiveness
Herpes zoster
Incremental cost-effectiveness ratio
Markov model
Postherpetic neuralgia
Quality-adjusted life years
title Cost-Effectiveness of the Adjuvant Recombinant Zoster Vaccine in Japanese Adults Aged 65 Years and Older
title_full Cost-Effectiveness of the Adjuvant Recombinant Zoster Vaccine in Japanese Adults Aged 65 Years and Older
title_fullStr Cost-Effectiveness of the Adjuvant Recombinant Zoster Vaccine in Japanese Adults Aged 65 Years and Older
title_full_unstemmed Cost-Effectiveness of the Adjuvant Recombinant Zoster Vaccine in Japanese Adults Aged 65 Years and Older
title_short Cost-Effectiveness of the Adjuvant Recombinant Zoster Vaccine in Japanese Adults Aged 65 Years and Older
title_sort cost effectiveness of the adjuvant recombinant zoster vaccine in japanese adults aged 65 years and older
topic Cost-effectiveness
Herpes zoster
Incremental cost-effectiveness ratio
Markov model
Postherpetic neuralgia
Quality-adjusted life years
url http://link.springer.com/article/10.1007/s13555-019-0291-4
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