OBJECTIVES: Community pharmacist plays an important role in providing vaccination to the general public. However, the impact on public health and economic benefits remains unknown. The objective of this study was to estimate the clinical and economic implications of community pharmacy-based herpes zoster (HZ) vaccination services with non-pharmacy-based immunization.

METHODS: A hybrid population-based model was developed to simulate a comparison between current practice with a hypothetical scenario without community pharmacy immunization services, based on the Utah population statistics to account for changes in vaccination rates and population size over time. The model compared no vaccination to vaccination with Zostavax or Shingrix (one or two doses) from the societal perspective. The model also allowed unvaccinated patients to be vaccinated at subsequent years following the initial cycle. Patients could experience shingles, postherpetic neuralgia (PHN), hospitalization, HZ ophthalmicus, monocular blindness, recovery, or death. The immunization landscape in the hypothetical scenario where pharmacists were not allowed to vaccinate was estimated based on an observational study and the actual proportion of vaccinated patients against shingles in each year was obtained from the annual Utah Immunization Coverage Report between the years 2010 and 2019. A lifetime time horizon was used. The discount rate of 3% was applied to costs and outcomes. All analyses were performed using Microsoft Excel 2010 (Microsoft Corp, Redmond, WA).

RESULTS: Based on a cohort of 853,550 people eligible for shingles immunization, an additional 11,576 individuals were vaccinated in the current scenario compared to the hypothetical scenario, resulting in 706 averted cases of shingles and 143 averted cases of PHN. Community pharmacy-based HZ vaccination (current scenario) was less costly (-$0.15) and gained more quality-adjusted life years (0.00006) compared to the hypothetical scenario.

CONCLUSIONS: Community pharmacy-based HZ vaccination was associated with lower cost and greater outcomes.