COST-EFFECTIVENESS ANALYSIS OF RECOMBINANT ZOSTER VACCINE VERSUS NO VACCINATION IN ADULTS AGED 50 YEARS AND OLDER: A SAUDI CHI PRIVATE SECTOR PERSPECTIVE
Author(s)
Hussain Abdulrahman Al-Omar, MSc, PhD1, Batool Alosaimi, MD, MPH2, Abdulmohsen Bakhsh, MD3, Mohamed E. Hassan, II, MSc2, Hany Soliman, MD2.
1Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia, 2Medical Affairs, GSK, Jeddah, Saudi Arabia, 3Cell and Stem cell Unit, Kidney & Pancreas Health Centre, Organ Transplant Centre of Excellence, King Faisal Specialist Hospital & Research Centre, Alfaisal University, Riyadh, Saudi Arabia.
1Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia, 2Medical Affairs, GSK, Jeddah, Saudi Arabia, 3Cell and Stem cell Unit, Kidney & Pancreas Health Centre, Organ Transplant Centre of Excellence, King Faisal Specialist Hospital & Research Centre, Alfaisal University, Riyadh, Saudi Arabia.
OBJECTIVES: This study evaluated the cost-effectiveness of the recombinant zoster vaccine (RZV) for preventing herpes zoster (HZ) in adults aged 50 years and older. The economic model was developed from the Saudi private sector perspective to inform a potential inclusion of the RZV in the Council of Health Insurance (CHI) essential benefits package.
METHODS: The ZOster ecoNomic Analysis (ZONA) model was developed in Microsoft Excel as a multi-cohort Markov model for adults aged ≥50 years. The model simulates 100,000 individuals over their remaining lifetimes with annual cycles. Second-dose compliance was assumed to be 69%. Vaccine efficacy parameters were sourced from the ZOE 50/70 (1 dose) ZOE-LFTU (2 doses) trials. HZ incidence and postherpetic neuralgia (PHN) probabilities were derived from the literature; HZ complication rates were captured from the “nphies” database. Unit costs and resource utilization were estimated using a micro-costing approach informed by local literature, Saudi costing data, and Saudi clinical and economic experts. Utility values were adapted from a Canadian study and mapped using the Saudi EQ-5D-5L tariff to reflects Saudi population preferences to the model health states. Costs and outcomes were discounted at 3% per year. Deterministic and probabilistic sensitivity analyses were employed as part of the analysis.
RESULTS: Compared with no vaccination, RZV was projected to avert 4,744 HZ cases, 876 PHN cases, and 1,100 additional HZ-related complications. The incremental cost-effectiveness ratio was 46,991 SAR per QALY gained from the private sector perspective and 18,461 SAR per QALY from the societal perspective. Outcomes were robust across sensitivity analyses.
CONCLUSIONS: From private sector perspective, administration of RZV for adults aged 50 years and older years is cost-effective versus no vaccination considering Saudi willingness to pay threshold (75,000 SAR) and supports consideration for inclusion in the CHI essential benefits package.
METHODS: The ZOster ecoNomic Analysis (ZONA) model was developed in Microsoft Excel as a multi-cohort Markov model for adults aged ≥50 years. The model simulates 100,000 individuals over their remaining lifetimes with annual cycles. Second-dose compliance was assumed to be 69%. Vaccine efficacy parameters were sourced from the ZOE 50/70 (1 dose) ZOE-LFTU (2 doses) trials. HZ incidence and postherpetic neuralgia (PHN) probabilities were derived from the literature; HZ complication rates were captured from the “nphies” database. Unit costs and resource utilization were estimated using a micro-costing approach informed by local literature, Saudi costing data, and Saudi clinical and economic experts. Utility values were adapted from a Canadian study and mapped using the Saudi EQ-5D-5L tariff to reflects Saudi population preferences to the model health states. Costs and outcomes were discounted at 3% per year. Deterministic and probabilistic sensitivity analyses were employed as part of the analysis.
RESULTS: Compared with no vaccination, RZV was projected to avert 4,744 HZ cases, 876 PHN cases, and 1,100 additional HZ-related complications. The incremental cost-effectiveness ratio was 46,991 SAR per QALY gained from the private sector perspective and 18,461 SAR per QALY from the societal perspective. Outcomes were robust across sensitivity analyses.
CONCLUSIONS: From private sector perspective, administration of RZV for adults aged 50 years and older years is cost-effective versus no vaccination considering Saudi willingness to pay threshold (75,000 SAR) and supports consideration for inclusion in the CHI essential benefits package.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE291
Topic
Economic Evaluation, Health Policy & Regulatory
Disease
Vaccines