Clinical and economic impact of herpes zoster vaccination in elderly in Italy

Figures & data

Table 1. Clinical and economic impact of HZ vaccination in elderly in Italy in 5 years.

Multi-cohort HZ vaccination	1 cohort/ year	2 cohorts/ year	3 cohorts/ year
Age of vaccinated cohorts	60 years	60 and 65 years	60, 65 and 70 years
N° of subjects in the vaccinated cohorts	3,928,318	7,535,272	10,946,807
N° of vaccinated cohorts in 5 years	5	10	15
Avoided cases
HZ	30,727	49,359	68,265
PHN	2,552	5,589	10,181
Ophthalmic HZ	0	871	2,269
Hospitalisations due to HZ	331	775	1,097
Hospitalisations due to PHN	23	62	120
Hospitalisations due to HZ with ophthalmic complications	54	128	181
Deaths	1	2	4
NHS perspective
Clinical savings	3,792,647	6,790,924	11,259,971
Vaccination costs	174,793,305	335,807.,418	486,312,224
Total net costs	171,000,658	329,016,494	475,052,254
Total net costs per vaccinated cohort	34,200,132	32,901,649	31,670,150
Societal perspective
Clinical savings	16,847,543	26,056,234	32,763,683
Vaccination costs	174,793,305	335,807,418	486,312,224
Total net costs	157,945,762	309,751,184	453,548,542
Total net costs per vaccinated cohort	31,589,152	30,975,118	30,236,569

Table 2. Clinical and economic evaluation of mono-cohort HZ vaccination in elderly in Italy in 5 years.

Mono-cohort HZ vaccination	1 cohort/ year	1 cohort/ year	1 cohort/ year
Age of vaccinated cohorts	60 years	65 years	70 years
N° of subjects in the vaccinated cohorts	3,928,318	3,606,954	3,411,535
N° of vaccinated cohorts in 5 years	5	5	5
Avoided cases
HZ	30,727	18,632	18,906
PHN	2,552	3,037	4,592
Ophthalmic HZ	0	871	1,398
Hospitalisations due to HZ	331	444	322
Hospitalisations due to PHN	23	39	58
Hospitalisations due to HZ with ophthalmic complications	54	74	53
Deaths	1	1	2
NHS perspective
Clinical savings	3,792,647	2,998,278	4,469,046
Vaccination costs	174,793,305	161,014,114	150,504,806
Total net costs	171,000,658	158,015,836	146,035,760
Total net costs per vaccinated cohort	34,200,132	31,603,167	29,207,152
Societal perspective
Clinical savings	16,847,543	9,208,692	6,707,448
Vaccination costs	174,793,305	161,014,114	150,504,806
Total net costs	157,945,762	151,805,422	143,797,358
Total net costs per vaccinated cohort	31,589,152	15,180,542	9,586,491

Table 3. Clinical and economic evaluation of HZ vaccination in the elderly in Italy with increasing vaccination coverage.

Multi-cohort HZ vaccination	1 cohort/ year	2 cohorts/ year	3 cohorts/ year
Age of vaccinated cohorts	60 years	60 and 65 years	60, 65 and 70 years
Avoided cases
HZ	22,284	35,629	49,781
PHN	1,850	4,025	7,465
Ophthalmic HZ	0	624	1,670
Hospitalisations due to HZ	240	558	799
Hospitalisations due to PHN	17	45	88
Hospitalisations due to HZ with ophthalmic complications	39	92	132
Deaths	1	1	3
NHS perspective
Clinical savings	2,733,784	4,868,401	8,194,698
Vaccination costs	140,874,029	269,232,076	393,895,336
Total net costs	138,140,246	264,363,675	385,700,638
Total net costs per vaccinated cohort	27,628,049	26,436,367	25,713,376
Societal perspective
Clinical savings	12,143,707	18,700,384	23,692,394
Vaccination costs	140,874,029	269,232,076	393,895,336
Total net costs	128,730,322	250,531,692	370,202,942
Total net costs per vaccinated cohort	25,746,064	25,053,169	24,680,196

Table 4. Clinical and economic evaluation of vaccination in the elderly in Italy with the effectiveness data of HZ vaccine.

Multi-cohort HZ vaccination	1 cohort/ year	2 cohorts/ year	3 cohorts/ year
Age of vaccinated cohorts	60 years	60 and 65 years	60, 65 and 70 years
Avoided cases
HZ	23,081	37,077	61,213
PHN	2,291	5,019	9,075
Ophthalmic HZ	0	654	2,439
Hospitalisations due to HZ	249	582	993
Hospitalisations due to PHN	21	56	107
Hospitalisations due to HZ with ophthalmic complications	40	96	163
Deaths	1	1	4
NHS perspective
Clinical savings	2,976,563	5,283,134	10,190,231
Vaccination costs	174,793,305	335,807,418	486,312,224
Total net costs	171,816,742	330,524,284	476,121,993
Total net costs per vaccinated cohort	34,363,348	33,052,428	31,741,466
Societal perspective
Clinical savings	12,801,348	19,848,629	27,255,213
Vaccination costs	174,793,305	335,807,418	486,312,224
Total net costs	161,991,957	315,958,789	459,057,012
Total net costs per vaccinated cohort	32,398,391	31,595,879	30,603,801

Table 5. Clinical and economic evaluation of HZ vaccination in the elderly in Italy with loss of protection over the time.

Multi-cohort HZ vaccination	1 cohort/ year	2 cohorts/ year	3 cohorts/ year
Age of vaccinated cohorts	60 years	60 and 65 years	60, 65 and 70 years
Avoided cases
HZ	23,566	37,804	51,662
PHN	1,957	4,278	7,645
Ophthalmic HZ	0	665	1,690
Hospitalisations due to HZ	254	593	829
Hospitalisations due to PHN	18	48	90
Hospitalisations due to HZ with ophthalmic complications	41	98	137
Deaths	1	1	3
NHS perspective
Clinical savings	2,920,329	5,220,971	8,511,154
Vaccination costs	174,793,305	335,807,418	486,312,224
Total net costs	171,872,976	330,586,447	477,801,070
Total net costs per vaccinated cohort	34,374,595	33,058,645	31,853,405
Societal perspective
Clinical savings	12,972,965	20,039,696	24,977,944
Vaccination costs	174,793,305	335,807,418	486,312,224
Total net costs	161,820,339	315,767,723	461,334,280
Total net costs per vaccinated cohort	32,364,068	31,576,772	30,755,619

Table 6. Clinical and economic evaluation of HZ vaccination in the elderly in Italy with increasing vaccination coverage, effectiveness data and loss of protection over the time.

Multi-cohort HZ vaccination	1 cohort/ year	2 cohorts/ year	3 cohorts/ year
Age of vaccinated cohorts	60 years	60 and 65 years	60, 65 and 70 years
Avoided cases
HZ	13,252	21,161	34,888
PHN	1,315	2,856	5,165
Ophthalmic HZ	0	370	1,385
Hospitalisations due to HZ	143	331	565
Hospitalisations due to PHN	12	32	61
Hospitalisations due to HZ with ophthalmic complications	23	55	93
Deaths	0	1	2
NHS perspective
Clinical savings	1,703,715	3,003,427	5,788,117
Vaccination costs	140,874,029	269,232,076	393,895,336
Total net costs	139,170,315	266,228,649	388,107,219
Total net costs per vaccinated cohort	27,834,063	26,622,865	25,873,815
Societal perspective
Clinical savings	7,327,277	11,298,967	15,501,790
Vaccination costs	140,874,029	269,232,076	393,895,336
Total net costs	133,546,752	257,933,109	378,393,546
Total net costs per vaccinated cohort	26,709,350	25,793,311	25,226,236

Figure 1. Decision tree and health states related to HZ included in the mathematical model.