Global Health Outcomes, Merck & Co., Inc., West Point, PA, USA.
Department of Market Access and Economics, Sanofi Pasteur MSD, France.
Vaccine. 2014 Mar 26;32(15):1645-53. doi: 10.1016/j.vaccine.2014.01.058. Epub 2014 Feb 15.
The objective of this study was to systematically review cost-effectiveness studies of vaccination against herpes zoster (HZ) and postherpetic neuralgia (PHN).
We searched MEDLINE and EMBASE databases for eligible studies published prior to November 2013. We extracted information regarding model structure, model input parameters, and study results. We compared the results across studies by projecting the health and economic impacts of vaccinating one million adults over their lifetimes.
We identified 15 cost-effectiveness studies performed in North America and Europe. Results ranged from approximately US$10,000 to more than US$100,000 per quality-adjusted life years (QALY) gained. Most studies in Europe concluded that zoster vaccination is likely to be cost-effective. Differences in results among studies are largely due to differing assumptions regarding duration of vaccine protection and a loss in quality of life associated with HZ and to a larger extent, PHN. Moreover, vaccine efficacy against PHN, age at vaccination, and vaccine cost strongly influenced the results in sensitivity analyses.
Most studies included in this review shows that vaccination against HZ is likely to be cost-effective. Future research addressing key model parameters and cost-effectiveness studies in other parts of the world are needed.
本研究旨在系统评价带状疱疹（HZ）和疱疹后神经痛（PHN）疫苗接种的成本效益研究。
我们检索了 MEDLINE 和 EMBASE 数据库，以获取截至 2013 年 11 月前发表的合格研究。我们提取了有关模型结构、模型输入参数和研究结果的信息。我们通过预测接种一百万名成年人一生的健康和经济影响来比较研究结果。
我们确定了 15 项在北美和欧洲进行的成本效益研究。结果范围从每获得一个质量调整生命年（QALY）的约 10000 美元到超过 100000 美元。欧洲的大多数研究都得出结论，带状疱疹疫苗接种可能具有成本效益。研究结果的差异主要是由于对疫苗保护持续时间的不同假设以及与 HZ 和更广泛的 PHN 相关的生活质量下降。此外，疫苗对 PHN 的疗效、接种年龄和疫苗成本在敏感性分析中强烈影响了结果。
本综述中包含的大多数研究表明，带状疱疹疫苗接种可能具有成本效益。需要进一步研究关键模型参数，并在世界其他地区开展成本效益研究。
