Value Evidence, GSK, Wavre, Belgium.
Value Evidence Freelance c/o GSK, Wavre, Belgium.
Hum Vaccin Immunother. 2021 Dec 2;17(12):5296-5303. doi: 10.1080/21645515.2021.2002085. Epub 2021 Dec 14.
The aim of the study was to update previously published public health impact and cost-effectiveness analyses of the recombinant zoster vaccine (RZV), in the German population aged ≥50 years of age (YOA), with the latest vaccine efficacy (VE) estimates against herpes zoster (HZ). The updated estimates are derived from a long-term follow-up study. A previously published multi-cohort Markov model following age cohorts over their lifetime was used. Demographic, epidemiological, cost, and utility data were based on German specific sources. Vaccine coverage was assumed to be 40%, with a second dose compliance of 70%. The estimated VE at time 0 was 98.9% (95% C.I.: 94.0-100%) with an annual waning of 1.5% (95% CI: 0.0-3.4%) for the age group 50-69 YOA. Corresponding values were 95.4% (95% C.I.: 89.7-100%) and 2.3% (95% CI: 0.3-4.4%) for the age group ≥70 YOA. It was estimated that, over the remaining lifetime since vaccination, RZV would prevent approximately 884 thousand (K), 603 K, and 538 K HZ cases in three age cohorts 50-59, 60-69, and ≥70 YOA, respectively. The number needed to vaccinate to prevent one HZ and one postherpetic neuralgia case was 6 and 36 (50-59 YOA cohort), 6 and 34 (60-69 YOA cohort), 10 and 48 (≥70 YOA cohort). The incremental cost-effectiveness ratio of vaccination ranged from €26 K/quality-adjusted life year (QALY) in 60 YOA to €35 K/QALY in 70 YOA. Due to the higher, sustained, RZV VE, improved public health and cost-effectiveness results were observed compared to previous analyses.
本研究旨在更新先前发表的关于重组带状疱疹疫苗（RZV）在德国≥50 岁人群中的公共卫生影响和成本效益分析，该分析采用了最新的带状疱疹疫苗效力（VE）估计值。更新后的估计值源自一项长期随访研究。此前发表的多队列马尔可夫模型用于跟踪各年龄段人群的终生情况。人口统计学、流行病学、成本和效用数据基于德国特定来源。假设疫苗覆盖率为 40%，第二剂接种率为 70%。0 时的估计 VE 为 98.9%（95%置信区间：94.0-100%），50-69 岁年龄组每年 VE 衰减 1.5%（95%置信区间：0.0-3.4%）。相应的数值为 95.4%（95%置信区间：89.7-100%）和 2.3%（95%置信区间：0.3-4.4%），年龄组≥70 岁。据估计，在接种疫苗后的剩余寿命内，RZV 将分别预防三个年龄组（50-59、60-69 和≥70 岁）中约 88.4 万、60.3 万和 53.8 万例带状疱疹病例。预防一例带状疱疹和一例带状疱疹后神经痛病例所需的疫苗接种人数分别为 6 人和 36 人（50-59 岁年龄组）、6 人和 34 人（60-69 岁年龄组）、10 人和 48 人（≥70 岁年龄组）。接种疫苗的增量成本效益比在 60 岁时为 26 千欧元/质量调整生命年（QALY），在 70 岁时为 35 千欧元/QALY。由于 RZV 的 VE 更高且持续，与之前的分析相比，该疫苗在公共卫生和成本效益方面的效果得到了改善。
