COST-EFFECTIVENESS OF HERPES ZOSTER VACCINATION STRATEGIES IN JAPAN
Author(s)
Mia Kobayashi, PhD1, Ataru Igarashi, PhD2, Yuriko Hagiwara, PhD2, Ayako Shoji, PhD2, Hiroshi Yoshihara, MS2, Shunya Ikeda, MD, PhD3.
1Yamanashi University, Chuo-shi, Japan, 2Keio University, Tokyo, Japan, 3International University of Health and Welfare/Keio University, Tokyo, Japan.
1Yamanashi University, Chuo-shi, Japan, 2Keio University, Tokyo, Japan, 3International University of Health and Welfare/Keio University, Tokyo, Japan.
OBJECTIVES: Herpes zoster (HZ) causes considerable morbidity and costs in aging societies, mainly through postherpetic neuralgia (PHN). In Japan, a one-dose live attenuated varicella vaccine and a two-dose adjuvanted recombinant zoster vaccine (RZV) are available for adults aged ≥50 years. We evaluated the cost-effectiveness of alternative HZ vaccination strategies in Japan.
METHODS: A cost-utility analysis using a Markov model compared no vaccination, live vaccine, and RZV. Cohorts aged 50, 55, 60, 65, 70, 75, and 80 years, and population strategies targeting adults above specified age thresholds, were assessed. Japanese epidemiologic data, medical costs, vaccine effectiveness, duration of protection, and quality-of-life losses were incorporated. Outcomes were costs, QALYs, and ICERs. The willingness-to-pay threshold was JPY 5 million per QALY. The base case assumed live-vaccine PHN protection of 50% in year 1 and 25% in years 2-7. Scenario analyses varied PHN prevention, utility loss, HZ incidence, and age-specific effectiveness.
RESULTS: Compared with no vaccination, at least one vaccination strategy was cost-effective in all age groups at the JPY 5 million threshold. In single-age cohorts, live vaccine ICERs ranged from JPY 2.42 to 3.55 million/QALY, whereas RZV ICERs ranged from JPY 2.02 to 5.68 million/QALY. RZV was preferred at ages 50-65 years. At ages 70, 75, and 80 years, live vaccine was preferred. In age-threshold strategies, RZV was preferred for programs targeting adults aged ≥50 or ≥60 years, whereas live vaccine was preferred for programs targeting adults aged ≥55, ≥65, or ≥70 years. Scenario analyses showed conclusions for older cohorts were sensitive to PHN protection, utility loss, incidence, and waning effectiveness.
CONCLUSIONS: HZ vaccination is economically attractive in Japan at a JPY 5 million/QALY threshold under base-case assumptions and sensitivity analyses. RZV offers better value for adults aged 50-65 years and selected age-threshold programs, while live vaccine may be more efficient for older or narrower target populations.
METHODS: A cost-utility analysis using a Markov model compared no vaccination, live vaccine, and RZV. Cohorts aged 50, 55, 60, 65, 70, 75, and 80 years, and population strategies targeting adults above specified age thresholds, were assessed. Japanese epidemiologic data, medical costs, vaccine effectiveness, duration of protection, and quality-of-life losses were incorporated. Outcomes were costs, QALYs, and ICERs. The willingness-to-pay threshold was JPY 5 million per QALY. The base case assumed live-vaccine PHN protection of 50% in year 1 and 25% in years 2-7. Scenario analyses varied PHN prevention, utility loss, HZ incidence, and age-specific effectiveness.
RESULTS: Compared with no vaccination, at least one vaccination strategy was cost-effective in all age groups at the JPY 5 million threshold. In single-age cohorts, live vaccine ICERs ranged from JPY 2.42 to 3.55 million/QALY, whereas RZV ICERs ranged from JPY 2.02 to 5.68 million/QALY. RZV was preferred at ages 50-65 years. At ages 70, 75, and 80 years, live vaccine was preferred. In age-threshold strategies, RZV was preferred for programs targeting adults aged ≥50 or ≥60 years, whereas live vaccine was preferred for programs targeting adults aged ≥55, ≥65, or ≥70 years. Scenario analyses showed conclusions for older cohorts were sensitive to PHN protection, utility loss, incidence, and waning effectiveness.
CONCLUSIONS: HZ vaccination is economically attractive in Japan at a JPY 5 million/QALY threshold under base-case assumptions and sensitivity analyses. RZV offers better value for adults aged 50-65 years and selected age-threshold programs, while live vaccine may be more efficient for older or narrower target populations.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EE34
Topic
Economic Evaluation
Disease
STA: Vaccines