Cost and health impact analysis of herpes zoster vaccination in Norway

ABSTRACT

Background

A decision analytic model was developed to estimate the cost-effectiveness of a national vaccination program against herpes zoster in Norway.

Methods

The model analyzed six vaccination scenarios that included the live-attenuated zoster vaccine under different target ages of vaccination (60, 65, and 70 years) compared with no vaccination. A catch-up program implemented in the first year of the vaccination was included in three of the scenarios. The model followed the population of Norway over a 40-year time horizon to estimate costs and outcomes associated with vaccination. Immunization costs, costs related to herpes zoster (both healthcare sector and non-healthcasre sector), the quality of life gains due to avoided cases of herpes zoster, and quality-of-life losses due to vaccine-related adverse events were estimated.

Results and Conclusions

A national vaccination program would result in reduction of the number of herpes zoster cases and decreased burden of illness. Vaccinating adults at 65 years of age with catch-up up to 70 years in the first year of the program was the most cost-effective strategy with the incremental cost per quality-adjusted life-year gained at NOK (Norwegian Krone) 245,459 from the societal perspective and NOK 248,637 from the health care system perspective.

KEYWORDS:

• Herpes zoster
• pharmacoeconomics
• vaccination
• cost-effectiveness
• Norway

Declaration of interest

J Graham and Z Yi are employees of RTI Health Solutions that received funds from Merck and Co., Inc to perform this study.

T Wisløff received funds from Merck Sharp & Dohme Corp to perform this study.

K Johnson is an employee of Merck and Co., Inc.

E Flem is employed by Merck Sharp & Dohme Corp. Merck and Co., Inc. is the manufacturer of the live-attenuated herpes zoster vaccine.

The author(s) have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

A reviewer on this paper received fees for attendance at an Advisory Board for MSD in March 2019. Reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Author contributions

All authors were involved in the conception, design, the analysis, and interpretation of the study results. J Graham and Z Yi were involved in drafting of the manuscript. All authors were responsible for revising it critically for intellectual content and the final approval of the version to be published. All authors agree to be accountable for all aspects of the work.

Supplementary material

Supplemental data for this article can be accessed here.

Additional information

Funding

Funding for this study was provided by Merck and Co., Inc.