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Cost-effectiveness analysis of vaccination with recombinant zoster vaccine among hematopoietic cell transplant recipients and persons with other immunocompromising conditions aged 19–49 years
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2 2023
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Source: Value Health. 26(2):204-215
[PDF-475.79 KB]
Details:
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Alternative Title:Value Health
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Personal Author:
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Description:Objectives:
Estimate the cost-effectiveness of the use of recombinant zoster vaccine (RZV, Shingrix), which protects against herpes zoster (HZ), among immunocompromised adults aged 19–49 years, as a contribution to deliberations of the Advisory Committee on Immunization Practices (ACIP).
Methods:
Hematopoietic cell transplant (HCT) recipients experience a high incidence of HZ, and the efficacy of RZV in preventing HZ has been studied in clinical trials. The cost-effectiveness model calculated incremental cost-effectiveness ratios that compared vaccination with RZV to a no vaccination strategy among adults aged 19–49 years. Costs and outcomes were calculated until age 50 using the health care sector perspective and summarized as cost per quality-adjusted life-year gained ($/QALY). The base case represents HCT recipients, with scenario analyses representing persons with other immunocompromising conditions, including hematologic malignancies, HIV, and autoimmune and inflammatory conditions. Uncertainty was investigated using univariate, multivariate, and probabilistic sensitivity analyses.
Results:
Base case results indicated vaccination with RZV would avert about 35% of HZ episodes and complications, while saving about 11% of net costs. Compared to no vaccination, vaccination of HCT recipients with RZV generated cost-savings (i.e., lower costs and improved health) in the base case and in 81% of simulations in the probabilistic analysis. In scenario analyses, vaccination cost $9,500/QALY among patients with hematologic malignancies, $79,000/QALY among persons living with HIV, and $208,000/QALY among persons with selected autoimmune and inflammatory conditions.
Conclusions:
Generally favorable economic estimates supported recommendations for vaccination of immunocompromised adults with RZV to prevent episodes of HZ and related complications.
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Source:
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Pubmed ID:36243666
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Pubmed Central ID:PMC11309022
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Document Type:
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Funding:
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Volume:26
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Issue:2
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