Cost Effectiveness of Recombinant Zoster Vaccine and Live-Attenuated Vaccine Against Herpes Zoster for Adults Aged 50 and Over in China.

IF 2.1 Q2 ECONOMICS

PharmacoEconomics Open Pub Date : 2025-09-09 DOI:10.1007/s41669-025-00604-z

Lulu Liu, Qilin Zhang, Yamin Shu, Lei Wang, Zhenqingyun Shuai, Mingming Chu, Zhe Zhang, Rong Zhang

{"title":"Cost Effectiveness of Recombinant Zoster Vaccine and Live-Attenuated Vaccine Against Herpes Zoster for Adults Aged 50 and Over in China.","authors":"Lulu Liu, Qilin Zhang, Yamin Shu, Lei Wang, Zhenqingyun Shuai, Mingming Chu, Zhe Zhang, Rong Zhang","doi":"10.1007/s41669-025-00604-z","DOIUrl":null,"url":null,"abstract":"Objective: Two vaccines against herpes zoster (HZ) are currently authorized for use in China: the adjuvanted recombinant zoster vaccine (RZV) and live-attenuated Zoster Vaccine Live (ZVL). The significant disparities in prices and efficacy between the two vaccines necessitate an evaluation of their relative value in order to make an informed choice. This study aimed to evaluate the comparative cost effectiveness of RZV, ZVL, and no vaccination for older adults at different ages from the societal perspective.Methods: The Markov decision model was parameterized using vaccine efficacy data, the latest incidence rates, costs, and health-related quality-of-life data. Participants consisted of a cohort comprising adults aged ≥ 50 years in China. The lifetime health impacts, cost, life-year (LY), quality-adjusted life-year (QALY) gained and the incremental cost-effectiveness ratio (ICER), net monetary benefits (NMB), net health benefits (NHB), and expected value of perfect information (EVPI) were calculated. Sensitivity analyses, scenario analyses, and subgroup analyses were performed.Results: Compared with no vaccination, RZV and ZVL could avoid 2,009,292 versus 510,192 HZ cases, and 334,637 versus 90,996 post-herpetic neuralgia (PHN) cases in the overall cohort, respectively. RZV and ZVL were more costly by US$1624 million versus US$896 million compared with no vaccination, with an additional 58,180 versus 23,390 QALYs. At threefold gross domestic product per capita, RZV had cost-effectiveness probabilities of 47.37% for ages 50-59 years, 83.24% for ages 60-69 years, 28.28% for ages 70-79 years, and 51.93% for ages ≥ 80 years, while ZVL had 7.07%, 12.79%, 69.55%, 2.82% probability, and no vaccination had 45.56%, 3.97%, 2.17%, 45.25% probability of being cost effective for the corresponding age cohorts.Conclusions: The strategy utilizing RZV demonstrated superior efficacy in reducing the burden of HZ compared with ZVL. RZV was most cost effective in the 50-59, 60-69 and ≥ 80 years age groups, and ZVL was most cost effective in the 70-79 years group.","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":""},"PeriodicalIF":2.1000,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"PharmacoEconomics Open","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s41669-025-00604-z","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ECONOMICS","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: Two vaccines against herpes zoster (HZ) are currently authorized for use in China: the adjuvanted recombinant zoster vaccine (RZV) and live-attenuated Zoster Vaccine Live (ZVL). The significant disparities in prices and efficacy between the two vaccines necessitate an evaluation of their relative value in order to make an informed choice. This study aimed to evaluate the comparative cost effectiveness of RZV, ZVL, and no vaccination for older adults at different ages from the societal perspective.

Methods: The Markov decision model was parameterized using vaccine efficacy data, the latest incidence rates, costs, and health-related quality-of-life data. Participants consisted of a cohort comprising adults aged ≥ 50 years in China. The lifetime health impacts, cost, life-year (LY), quality-adjusted life-year (QALY) gained and the incremental cost-effectiveness ratio (ICER), net monetary benefits (NMB), net health benefits (NHB), and expected value of perfect information (EVPI) were calculated. Sensitivity analyses, scenario analyses, and subgroup analyses were performed.

Results: Compared with no vaccination, RZV and ZVL could avoid 2,009,292 versus 510,192 HZ cases, and 334,637 versus 90,996 post-herpetic neuralgia (PHN) cases in the overall cohort, respectively. RZV and ZVL were more costly by US$1624 million versus US$896 million compared with no vaccination, with an additional 58,180 versus 23,390 QALYs. At threefold gross domestic product per capita, RZV had cost-effectiveness probabilities of 47.37% for ages 50-59 years, 83.24% for ages 60-69 years, 28.28% for ages 70-79 years, and 51.93% for ages ≥ 80 years, while ZVL had 7.07%, 12.79%, 69.55%, 2.82% probability, and no vaccination had 45.56%, 3.97%, 2.17%, 45.25% probability of being cost effective for the corresponding age cohorts.

Conclusions: The strategy utilizing RZV demonstrated superior efficacy in reducing the burden of HZ compared with ZVL. RZV was most cost effective in the 50-59, 60-69 and ≥ 80 years age groups, and ZVL was most cost effective in the 70-79 years group.

查看原文本刊更多论文

重组带状疱疹疫苗和减毒活疫苗在中国50岁及以上成人的成本效益

目的：目前在中国批准使用的带状疱疹（HZ）疫苗有两种：佐剂重组带状疱疹疫苗（RZV）和减毒带状疱疹活疫苗（ZVL）。这两种疫苗在价格和功效方面存在巨大差异，因此有必要对它们的相对价值进行评估，以便做出明智的选择。本研究旨在从社会角度评估不同年龄的老年人接种RZV、ZVL和不接种疫苗的比较成本效益。方法：利用疫苗有效性数据、最新发病率、成本和健康相关生活质量数据对马尔可夫决策模型进行参数化。参与者由年龄≥50岁的中国成年人组成。计算终身健康影响、获得的成本、生命年（LY）、质量调整生命年（QALY）和增量成本-效果比（ICER）、净货币效益（NMB）、净健康效益（NHB）和完美信息期望值（EVPI）。进行敏感性分析、情景分析和亚组分析。结果：与未接种疫苗相比，RZV和ZVL在整个队列中分别可以避免2,009,292例HZ病例和510,192例HZ病例，334,637例和90,996例疱疹后神经痛（PHN）病例。与不接种疫苗相比，RZV和ZVL的成本分别高出1.624亿美元和8.96亿美元，另外58,180个QALYs和23,390个QALYs的成本也更高。按人均国内生产总值（gdp）的3倍计算，50-59岁、60-69岁、70-79岁和≥80岁人群接种疫苗的成本-效果概率分别为47.37%、83.24%、28.28%和51.93%，而接种疫苗的成本-效果概率分别为7.07%、12.79%、69.55%、2.82%，未接种疫苗的成本-效果概率分别为45.56%、3.97%、2.17%和45.25%。结论：使用RZV的策略在减轻HZ负担方面优于zl。RZV在50-59岁、60-69岁和≥80岁年龄组中最具成本效益，ZVL在70-79岁年龄组中最具成本效益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

PharmacoEconomics Open Multiple-

CiteScore

3.50

自引率

0.00%

发文量

审稿时长

8 weeks

期刊介绍： PharmacoEconomics - Open focuses on applied research on the economic implications and health outcomes associated with drugs, devices and other healthcare interventions. The journal includes, but is not limited to, the following research areas:Economic analysis of healthcare interventionsHealth outcomes researchCost-of-illness studiesQuality-of-life studiesAdditional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in PharmacoEconomics -Open may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.All manuscripts are subject to peer review by international experts. Letters to the Editor are welcomed and will be considered for publication.