Cost-effectiveness of an adjuvanted recombinant zoster vaccine in older adults in the United States who have been previously vaccinated with zoster vaccine live

Zoster Vaccine Live (ZVL) is marketed in the US since 2008, and a non-live adjuvanted Recombinant Zoster Vaccine (RZV) was approved in 2017. Literature suggests that waning of ZVL efficacy may necessitate additional vaccination. The Advisory Committee on Immunization Practices recommended vaccinatio...

Full description

Bibliographic Details
Main Authors: Desmond Curran, Brandon J. Patterson, Desiree Van Oorschot, Philip O. Buck, Justin Carrico, Katherine A. Hicks, Bruce Lee, Barbara P. Yawn
Format: Article
Language:English
Published: Taylor & Francis Group 2019-04-01
Series:Human Vaccines & Immunotherapeutics
Subjects:
Online Access:http://dx.doi.org/10.1080/21645515.2018.1558689
_version_ 1797677445357240320
author Desmond Curran
Brandon J. Patterson
Desiree Van Oorschot
Philip O. Buck
Justin Carrico
Katherine A. Hicks
Bruce Lee
Barbara P. Yawn
author_facet Desmond Curran
Brandon J. Patterson
Desiree Van Oorschot
Philip O. Buck
Justin Carrico
Katherine A. Hicks
Bruce Lee
Barbara P. Yawn
author_sort Desmond Curran
collection DOAJ
description Zoster Vaccine Live (ZVL) is marketed in the US since 2008, and a non-live adjuvanted Recombinant Zoster Vaccine (RZV) was approved in 2017. Literature suggests that waning of ZVL efficacy may necessitate additional vaccination. The Advisory Committee on Immunization Practices recommended vaccination with RZV in immunocompetent adults aged 50+ years old, including those previously vaccinated with ZVL. The objective of this study was to determine the cost-effectiveness of vaccinating US adults aged 60+ years old, previously vaccinated with ZVL. The ZOster ecoNomic Analysis (ZONA) model, a deterministic Markov model, was adapted to follow a hypothetical 1 million(M)-person cohort of US adults previously vaccinated with ZVL. Model inputs included demographics, epidemiology, vaccine characteristics, utilities and costs. Costs and quality-adjusted life-years (QALYs) were presented over the lifetimes of the cohort from the year of additional vaccination, discounted 3% annually. The model estimated that, vaccination with RZV 5 years after previous vaccination with ZVL, would reduce disease burden compared with no additional vaccination, resulting in a gain of 1,633 QALYs at a total societal cost of $96M (incremental cost-effectiveness ratio: $58,793/QALY saved). Compared with revaccinating with ZVL, vaccination with RZV would result in a gain of 1,187 QALYs and societal cost savings of almost $84M. Sensitivity, scenario, and threshold analyses demonstrated robustness of these findings. Vaccination with RZV is predicted to be cost-effective relative to no additional vaccination, assuming a threshold of $100,000/QALY, and cost-saving relative to ZVL revaccination of US adults aged 60+ years old who have been previously vaccinated with ZVL.
first_indexed 2024-03-11T22:45:17Z
format Article
id doaj.art-e32a74a9e71e4cde9b0d2cb2e3ab1819
institution Directory Open Access Journal
issn 2164-5515
2164-554X
language English
last_indexed 2024-03-11T22:45:17Z
publishDate 2019-04-01
publisher Taylor & Francis Group
record_format Article
series Human Vaccines & Immunotherapeutics
spelling doaj.art-e32a74a9e71e4cde9b0d2cb2e3ab18192023-09-22T08:38:25ZengTaylor & Francis GroupHuman Vaccines & Immunotherapeutics2164-55152164-554X2019-04-0115476577110.1080/21645515.2018.15586891558689Cost-effectiveness of an adjuvanted recombinant zoster vaccine in older adults in the United States who have been previously vaccinated with zoster vaccine liveDesmond Curran0Brandon J. Patterson1Desiree Van Oorschot2Philip O. Buck3Justin Carrico4Katherine A. Hicks5Bruce Lee6Barbara P. Yawn7GSKGSKGSKGSKRTI Health SolutionsRTI Health SolutionsJohns-Hopkins UniversityUniversity of MinnesotaZoster Vaccine Live (ZVL) is marketed in the US since 2008, and a non-live adjuvanted Recombinant Zoster Vaccine (RZV) was approved in 2017. Literature suggests that waning of ZVL efficacy may necessitate additional vaccination. The Advisory Committee on Immunization Practices recommended vaccination with RZV in immunocompetent adults aged 50+ years old, including those previously vaccinated with ZVL. The objective of this study was to determine the cost-effectiveness of vaccinating US adults aged 60+ years old, previously vaccinated with ZVL. The ZOster ecoNomic Analysis (ZONA) model, a deterministic Markov model, was adapted to follow a hypothetical 1 million(M)-person cohort of US adults previously vaccinated with ZVL. Model inputs included demographics, epidemiology, vaccine characteristics, utilities and costs. Costs and quality-adjusted life-years (QALYs) were presented over the lifetimes of the cohort from the year of additional vaccination, discounted 3% annually. The model estimated that, vaccination with RZV 5 years after previous vaccination with ZVL, would reduce disease burden compared with no additional vaccination, resulting in a gain of 1,633 QALYs at a total societal cost of $96M (incremental cost-effectiveness ratio: $58,793/QALY saved). Compared with revaccinating with ZVL, vaccination with RZV would result in a gain of 1,187 QALYs and societal cost savings of almost $84M. Sensitivity, scenario, and threshold analyses demonstrated robustness of these findings. Vaccination with RZV is predicted to be cost-effective relative to no additional vaccination, assuming a threshold of $100,000/QALY, and cost-saving relative to ZVL revaccination of US adults aged 60+ years old who have been previously vaccinated with ZVL.http://dx.doi.org/10.1080/21645515.2018.1558689herpes zostervaccinationcost-effectivenessrevaccinationrecombinant zoster vaccineboosterolder adults
spellingShingle Desmond Curran
Brandon J. Patterson
Desiree Van Oorschot
Philip O. Buck
Justin Carrico
Katherine A. Hicks
Bruce Lee
Barbara P. Yawn
Cost-effectiveness of an adjuvanted recombinant zoster vaccine in older adults in the United States who have been previously vaccinated with zoster vaccine live
Human Vaccines & Immunotherapeutics
herpes zoster
vaccination
cost-effectiveness
revaccination
recombinant zoster vaccine
booster
older adults
title Cost-effectiveness of an adjuvanted recombinant zoster vaccine in older adults in the United States who have been previously vaccinated with zoster vaccine live
title_full Cost-effectiveness of an adjuvanted recombinant zoster vaccine in older adults in the United States who have been previously vaccinated with zoster vaccine live
title_fullStr Cost-effectiveness of an adjuvanted recombinant zoster vaccine in older adults in the United States who have been previously vaccinated with zoster vaccine live
title_full_unstemmed Cost-effectiveness of an adjuvanted recombinant zoster vaccine in older adults in the United States who have been previously vaccinated with zoster vaccine live
title_short Cost-effectiveness of an adjuvanted recombinant zoster vaccine in older adults in the United States who have been previously vaccinated with zoster vaccine live
title_sort cost effectiveness of an adjuvanted recombinant zoster vaccine in older adults in the united states who have been previously vaccinated with zoster vaccine live
topic herpes zoster
vaccination
cost-effectiveness
revaccination
recombinant zoster vaccine
booster
older adults
url http://dx.doi.org/10.1080/21645515.2018.1558689
work_keys_str_mv AT desmondcurran costeffectivenessofanadjuvantedrecombinantzostervaccineinolderadultsintheunitedstateswhohavebeenpreviouslyvaccinatedwithzostervaccinelive
AT brandonjpatterson costeffectivenessofanadjuvantedrecombinantzostervaccineinolderadultsintheunitedstateswhohavebeenpreviouslyvaccinatedwithzostervaccinelive
AT desireevanoorschot costeffectivenessofanadjuvantedrecombinantzostervaccineinolderadultsintheunitedstateswhohavebeenpreviouslyvaccinatedwithzostervaccinelive
AT philipobuck costeffectivenessofanadjuvantedrecombinantzostervaccineinolderadultsintheunitedstateswhohavebeenpreviouslyvaccinatedwithzostervaccinelive
AT justincarrico costeffectivenessofanadjuvantedrecombinantzostervaccineinolderadultsintheunitedstateswhohavebeenpreviouslyvaccinatedwithzostervaccinelive
AT katherineahicks costeffectivenessofanadjuvantedrecombinantzostervaccineinolderadultsintheunitedstateswhohavebeenpreviouslyvaccinatedwithzostervaccinelive
AT brucelee costeffectivenessofanadjuvantedrecombinantzostervaccineinolderadultsintheunitedstateswhohavebeenpreviouslyvaccinatedwithzostervaccinelive
AT barbarapyawn costeffectivenessofanadjuvantedrecombinantzostervaccineinolderadultsintheunitedstateswhohavebeenpreviouslyvaccinatedwithzostervaccinelive