Cost-effectiveness of the recombinant zoster vaccine (RZV) against herpes zoster: An updated critical review

Hum Vaccin Immunother. 2023 Dec 31;19(1):2168952. doi: 10.1080/21645515.2023.2168952. Epub 2023 Mar 14.

Abstract

The objective of this study was to critically review the cost-effectiveness (CE) of the recombinant zoster vaccine (RZV) against herpes zoster (HZ). A literature review was conducted in PubMed, Embase, and Cochrane between January 1, 2017, and February 28, 2022, and on select public healthcare agency websites to identify and collect data from CE studies comparing RZV to zoster vaccine live (ZVL) or to no vaccination. Study characteristics, inputs, and outputs were collected. The overall CE of RZV was assessed. RZV vaccination against HZ is cost-effective in 15 out of 18 studies included in the present review. Varying incremental cost-effectiveness ratios (ICERs) observed may be associated with different assumptions on the duration of protection of RZV, as well as different combinations of structural and disease-related study (model) inputs driving the estimation of ICERs.

Keywords: Herpes zoster; cost-effectiveness; older adults; recombinant zoster vaccine; vaccination.

Plain language summary

What is the context?• Herpes zoster, also known as shingles, may cause painful rashes and skin alterations.• Chronic pain, also referred to as post-herpetic neuralgia, may persist for months or even years after the initial rash.• The disease is caused by reactivation of the varicella zoster virus.• The recombinant zoster vaccine (RZV) and the zoster vaccine live (ZVL) are approved for the prevention of herpes zoster and post-herpetic neuralgia.• We reviewed published evidence from the past 5 years on RZV.What is new?• Out of 18 selected studies, RZV vaccination against herpes zoster and post-herpetic neuralgia is cost-effective in 15.• In the 15 studies establishing RZV cost-effectiveness, RZV is always cost-effective or frequently cost-saving in direct comparisons to ZVL, when applicable.• RZV was found cost-saving in several immune-compromised populations.What is the impact?• The overview of the currently available body of evidence related to cost-effectiveness of RZV may help informing decision makers about the value of vaccination against herpes zoster.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cost-Benefit Analysis
  • Herpes Zoster Vaccine*
  • Herpes Zoster* / prevention & control
  • Herpesvirus 3, Human
  • Humans
  • Neuralgia, Postherpetic* / prevention & control
  • Vaccination
  • Vaccines, Synthetic

Substances

  • Herpes Zoster Vaccine
  • Vaccines, Synthetic

Grants and funding

GlaxoSmithKline Biologicals SA funded this study/research (GSK study identifier: VeevaHO: VEO-000338) and was involved in all stages of study conduct, including analysis of the data. GlaxoSmithKline Biologicals SA also took in charge all costs associated with the development and publication of this manuscript.