Hostname: page-component-8448b6f56d-sxzjt Total loading time: 0 Render date: 2024-04-25T02:05:04.064Z Has data issue: false hasContentIssue false
  • English
  • Français

COST-EFFECTIVENESS ANALYSIS OF HERPES ZOSTER VACCINATION IN ITALIAN ELDERLY PERSONS

Published online by Cambridge University Press:  14 September 2016

Silvia Coretti ,
Paola Codella ,
Federica Romano Open the ORCID record for Federica Romano [Opens in a new window] ,
Matteo Ruggeri  and
Americo Cicchetti
Silvia Coretti
Affiliation:
Postgraduate School of Health Economics and Management, Università Cattolica del Sacro Cuore, Rome, Italysilvia.coretti@unicatt.it
Paola Codella
Affiliation:
Postgraduate School of Health Economics and Management, Università Cattolica del Sacro Cuore, Rome, Italy
Federica Romano
Affiliation:
Postgraduate School of Health Economics and Management, Università Cattolica del Sacro Cuore, Rome, Italy
Matteo Ruggeri
Affiliation:
Postgraduate School of Health Economics and Management, Università Cattolica del Sacro Cuore, Rome, Italy
Americo Cicchetti
Affiliation:
Director of Postgraduate School of Health Economics and Management, Università Cattolica del Sacro Cuore, Rome, Italy
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: Herpes zoster (HZ) is characterized by a painful skin rash. Its main complication is postherpetic neuralgia (PHN), pain persisting or occurring after the rash onset. HZ treatment aims to reduce acute pain, impede the onset complications, and disease progression. The aim of this study was to assess the cost-effectiveness of HZ vaccination compared with no vaccination strategy, within the Italian context.

Methods: The natural history of HZ and PHN was mapped through a Markov model with lifetime horizon. A population of patients aged between 60 and 79 years was hypothesized. Third party payer (Italian National Health Service, I-NHS) and societal perspectives were adopted. Data were derived from literature.

Results and Conclusions: The incremental cost-effectiveness ratio of the vaccination equaled EUR 11,943 per quality-adjusted life-year (QALY) under the I-NHS perspective and EUR 11,248 per QALY under the societal perspective. Considering a cost-effectiveness threshold of EUR 30,000/QALY, the multi-way sensitivity analysis showed that vaccination is cost-effective regardless of the perspective adopted, in 99 percent of simulations.

Keywords

Economic evaluationDecision modelHerpes zosterPrevention
Type
Assessments
Information
International Journal of Technology Assessment in Health Care , Volume 32 , Issue 4 , 2016 , pp. 233 - 240
Copyright
Copyright © Cambridge University Press 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Kimberlin, DW, Whitley, RJ. Varicella–Zoster vaccine for the prevention of herpes Zoster. N Engl J Med. 2007;356:1338–1343.Google Scholar
2. neuralgia, Hope-Simpson RE. Postherpetic. J R Coll Gen Pract. 1975;25:571–575.Google Scholar
3. Guenther, LC. Herpes zoster and postherpetic neuralgia. Expert Rev Dermatol. 2006;1:607–618.Google Scholar
4. Gialloreti, LE, Merito, M, Pezzotti, P, et al. Epidemiology and economic burden of herpes zoster and post-herpetic neuralgia in Italy: A retrospective, population-based study. BMC Infect Dis. 2010;10:230.Google Scholar
5. Oxman, MN, Levin, MJ, Johnson, GR, et al. A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. N Engl J Med. 2005;352:2271–2284.Google Scholar
6. Opstelten, W, Mauritz, JW, de Wit, NJ, et al. Herpes zoster and postherpetic neuralgia: Incidence and risk indicators using a general practice research database. Fam Pract. 2002;19:471–475.Google Scholar
7. Scott, FT, Leedham‐Green, ME, Barrett‐Muir, WY, et al. A study of shingles and the development of postherpetic neuralgia in East London. J Med Virol. 2003;70:S24-S30.Google Scholar
8. Bresse, X, Annemans, L, Préaud, E, et al. Vaccination against herpes zoster and postherpetic neuralgia in France: A cost-effectiveness analysis. Expert Rev Pharmacoecon Outcomes Res. 2013;13:393–406.Google Scholar
9. Moore, L, Remy, V, Martin, M, Beillat, M, Mcguire, A. A health economic model for evaluating a vaccine for the prevention of herpes zoster and post-herpetic neuralgia in the UK. Cost Eff Resour Alloc. 2010;8:7.CrossRefGoogle ScholarPubMed
10. Annemans, L, Bresse, X, Gobbo, C, Papageorgiou, M. Health economic evaluation of a vaccine for the prevention of herpes zoster (shingles) and post-herpetic neuralgia in adults in Belgium. J Med Econ. 2010;13:537–551.Google Scholar
11. Szucs, TD, Kressig, RW, Papageorgiou, M, et al. Economic evaluation of a vaccine for the prevention of herpes zoster and post-herpetic neuralgia in older adults in Switzerland. Hum Vaccin. 2011;7:749–756.Google Scholar
12. Johnson, R, McElhaney, J, Pedalino, B, Levin, M. Prevention of herpes zoster and its painful and debilitating complications. Int J Infect Dis. 2007;11 (Suppl 2):S43-S48.Google Scholar
13. ISTAT. Available at: http://www.istat.it (accessed July 25, 2016).Google Scholar
14. Volpi, A, Gatti, A, Serafini, G, et al. Clinical and psychosocial correlates of acute pain in herpes zoster. J Med Virol. 2007;38:275–279.Google Scholar
15. Volpi, A, Gatti, A, Pica, F, et al. Clinical and psychosocial correlates of post-herpetic neuralgia. J Med Virol. 2008;80:1646–1652.CrossRefGoogle ScholarPubMed
16. Thyregod, HG, Rowbotham, MC, Peters, M, et al. Natural history of pain following herpes zoster. Pain. 2007;128:148–156.CrossRefGoogle ScholarPubMed
17. Bricout, H, Perinetti, E, Marchettini, P, et al. Predictive factors for the presence of post herpetic neuralgia at 3 months in herpes zoster patients aged 50 and over in Italy: Results from a gp-based observational prospective multicenter study. ISPOR 16th Annual EU Conference Dublin, Ireland, November 3–6, 2013.Google Scholar
18. Rothberg, MB, Virapongse, A, Smith, KJ. Cost-effectiveness of a vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. Clin Infect Dis. 2007;44:1280–1288.Google Scholar
19. Schmader, KE, Levin, MJ, Gnann, JW Jr, et al. Efficacy, safety, and tolerability of herpes zoster vaccine in persons aged 50-59 years. Clin Infect Dis. 2012;54:922–928.Google Scholar
20. Pellissier, JM, Brisson, M, Levin, MJ. Evaluation of the cost-effectiveness in the United States of a vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. Vaccine. 2007;25:8326–8337.Google Scholar
21. Blank, PR, Schwenkglenks, M, Szucs, TD. Influenza vaccination coverage rates in five European countries during season 2006/07 and trends over six consecutive seasons. BMC Public Health. 2008;8:272.Google Scholar
22. Oster, G, Harding, G, Dukes, E, Edelsberg, J, Cleary, PD. Pain, medication use, and health-related quality of life in older persons with postherpetic neuralgia: Results from a population-based survey. J Pain. 2005;6:356–363.Google Scholar
23. Bala, MV, Wood, LL, Zarkin, GA, et al. Valuing outcomes in health care: A comparison of willingness to pay and quality-adjusted life-years. J Clin Epidemiol. 1998;51:667–676.Google Scholar
24. Italian Agency of Medicines. Database of authorized medicines. Online source. Available at: https://farmaci.agenziafarmaco.gov.it/bancadatifarmaci/cerca-farmaco (accessed August 2016).Google Scholar
25. Italian Agency of Medicines. Regime di rimborsabilità e prezzo di vendita del medicinale «Zostavax» (vaccino dello Zoster (vivo)), autorizzata con procedura centralizzata europea dalla Commissione europea. (Determinazione/C 371/2010). Online source. Available at: http://www.gazzettaufficiale.it/do/atto/serie_generale/caricaPdf?cdimg=10A0490400000010110012&dgu=2010-04-29&art.dataPubblicazioneGazzetta=2010-04-29&art.codiceRedazionale=10A04904&art.num=1&art.tiposerie=SG (accessed August 2016).Google Scholar
26. Mennini, FS, Baio, G, Montagano, G, et al. Governance of preventive health intervention and on time verification of its efficiency: The GIOVE study. BMJ Open. 2012;15:e000736.Google Scholar
27. Azzari, C, Massai, C, Poggiolesi, C, et al. Cost of varicella-related hospitalizations in an Italian paediatric hospital: Comparison with possible vaccination expenses. Curr Med Res Opin. 2007;23:2945–2954.Google Scholar
28. Coudeville, L, Brunot, A, Giaquinto, C, Lucioni, C, Dervaux, B. Varicella vaccination in Italy: An economic evaluation of different scenarios. Pharmacoeconomics. 2004;22:839–855.Google Scholar
29. Panatto, D, Bragazzi, NL, Rizzitelli, E, et al. Evaluation of the economic burden of Herpes Zoster (HZ) infection. A systematic literature review. Hum Vaccin Immunother. 2014;11:1–18.Google Scholar
30. Di Legami, V, Gianino, MM, Atti, MC, et al. Epidemiology and costs of herpes zoster: Background data to estimate the impact of vaccination. Vaccine. 2007;25:7598–7604.CrossRefGoogle ScholarPubMed
31. Ministero della Salute. National Health Care Range of Fees for specialist outpatient visits updated by Ministerial Decree dated October 18th, 2012. Available at: http://www.trovanorme.salute.gov.it/norme/renderpdf (accessed July 2014).Google Scholar
32. Indicatori del lavoro nelle imprese. Available at: www.istat.it (accessed September 16, 2014).Google Scholar
33. Mick, G, Gallais, JL, Simon, F, et al. Burden of herpes zoster and postherpetic neuralgia: Incidence, proportion, and associated costs in the French population aged 50 or over. Rev Epidemiol Santé Publique. 2010;58:393–401.Google Scholar
34. Culyer, AJ. NICE's use of cost-effectiveness as an example of deliberative process. Health Econ Policy Law. 2006;1:299–318.CrossRefGoogle Scholar
35. Garber, AM, Phelps, CE. Economic foundations of cost-effectiveness analysis. J Health Econ. 1997;16:1–31.Google Scholar
36. McKendrick, MW, McGill, JI, Wood, MJ. Lack of effect of acyclovir on postherpetic neuralgia. BMJ. 1989;298:431.CrossRefGoogle ScholarPubMed
37. Kawai, K, Preaud, E, Baron-Papillon, F, Largeron, N, Acosta, CJ. Cost-effectiveness of vaccination against herpes zoster and postherpetic neuralgia: A critical review. Vaccine. 2014;32:1645–1653.Google Scholar
38. Langan, SM, Smeeth, L, Margolis, DJ, Thomas, SL. Herpes zoster vaccine effectiveness against incident herpes zoster and post-herpetic neuralgia in an older US population: A cohort study. PLoS Med. 2013;10:e1001420.Google Scholar
39. Tseng, HF, Smith, N, Harpaz, R, et al. Herpes zoster vaccine in older adults and the risk of subsequent herpes zoster disease. JAMA. 2011;305:160–166.CrossRefGoogle ScholarPubMed
Supplementary material: File

Coretti supplementary material

Figure S1

Download Coretti supplementary material(File)
File 61.5 KB
Supplementary material: File

Coretti supplementary material

Figure S2A

Download Coretti supplementary material(File)
File 61.8 KB
Supplementary material: File

Coretti supplementary material

Figure S2B

Download Coretti supplementary material(File)
File 29.1 KB
Supplementary material: File

Coretti supplementary material

Figure S3A

Download Coretti supplementary material(File)
File 50.5 KB
Supplementary material: File

Coretti supplementary material

Figure S3B

Download Coretti supplementary material(File)
File 24.1 KB
Supplementary material: File

Coretti supplementary material

Table S1

Download Coretti supplementary material(File)
File 17.7 KB
Supplementary material: File

Coretti supplementary material

Table S2

Download Coretti supplementary material(File)
File 17.3 KB
Supplementary material: File

Coretti supplementary material

Table S3

Download Coretti supplementary material(File)
File 24.5 KB