OBJECTIVES

: Previous research demonstrated that >9 million (M) herpes zoster (HZ) cases could occur over the lifetime of the German population ≥50 years of age (YOA). HZ has a significant impact on the German health care system, resulting in annual costs of 182M €. Introducing the new adjuvanted recombinant zoster vaccine (RZV) could prevent a substantial amount of HZ and postherpetic neuralgia (PHN) cases. The present study aims to demonstrate the potential cost-effectiveness of the HZ vaccination program using RZV in the German population ≥50 YOA.

METHODS

: The ZOster ecoNomic Analysis (ZONA) model is a static, multi-cohort Markov model that followed 1 million (M) ≥50-year-old subjects over their lifetime from the year of vaccination. Model inputs are derived from published, German-specific literature. 2016 is used as baseline year for costs. Costs and outcomes were discounted at 3%. The societal perspective is presented. We assumed 40% coverage, with a second-dose compliance of 70%. The vaccine price for RZV was set at €106/dose (price to retailer). Model uncertainty is addressed by performing deterministic and probabilistic sensitivity analyses.

RESULTS

: Vaccinating 40% of a 1M cohort of the German population ≥50 YOA results in a reduction of 49,166 HZ and 8,728 PHN cases over lifetime. Vaccination costs are projected to be around 78M €, while avoiding 14M € and 6M € in direct and indirect costs, respectively. The QALY gain is estimated to be 1,652 resulting in an incremental cost-effectiveness ratio of 35,158 €/QALY from a societal perspective. The optimal age for HZ vaccination is 60-65 years of age. Sensitivity analyses show that the results are robust.

CONCLUSIONS

: Vaccination against HZ using RZV would reduce the burden of disease in the German population of ≥50 YOA. If we consider a hypothetical willingness-to-pay threshold of 50,000 €/QALY, RZV is cost-effective for this population.