Effectiveness and cost-effectiveness of vaccination against herpes zoster in Canada: a modelling study.

Effectiveness and cost-effectiveness of vaccination against herpes zoster in Canada: a modelling study. CMAJ. 2019 Aug 26;191(34):E932-E939 Authors: Drolet M, Zhou Z, Sauvageau C, DeWals P, Gilca V, Amini R, Bénard É, Brisson M Abstract BACKGROUND: Two vaccines against herpes zoster are currently authorized for use in Canada: the recombinant subunit zoster vaccine and live attenuated zoster vaccine. We compared the effectiveness and cost-effectiveness of these 2 vaccines. METHODS: We used a decision analytic static cohort model parametrized with Canadian epidemiologic and economic data. We performed the economic analysis from the health care system perspective, using a lifetime horizon and a 3% discount rate for costs and benefits. The primary outcome was the incremental cost per quality-adjusted life-year (QALY) gained, relative to no vaccination. We ran 30 000 simulations varying all model parameters, including vaccine costs, efficacy and waning. RESULTS: The number needed to vaccinate (NNV) was higher for the live attenuated zoster vaccine than for the recombinant subunit zoster vaccine for all herpes zoster-related events at all ages. For example, in persons exactly 65 years old, for herpes zoster, median NNV was 21 (90% uncertainty interval [UI] 13-31) versus 8 (90% UI 6-18), and for postherpetic neuralgia, NNV was 64 (90% UI 33-93) versus 31 (90% UI 23-73). For the recombinant vaccine, the median cost-effectiv...
Source: cmaj - Category: General Medicine Authors: Tags: CMAJ Source Type: research