title: The use of Zostavax in Spain: the economic case for vaccination of individuals aged 50 years and older.
abstract: Background Population aging brings up a number of health issues, one of which is an increased incidence of herpes zoster (HZ) and its complication, post-herpetic neuralgia (PHN). Zostavax vaccine has recently become available to prevent HZ and PHN. This study evaluates the cost-effectiveness of vaccination against HZ in Spain considering a vaccination of the population aged 50 years and older and comparing this to the current situation where no vaccination is being administered. Methods An existing, validated, and published economic model was adapted to Spain using relevant local input parameters and costs from 2013. Results Vaccinating 30% of the Spanish population aged 50 years and older resulted in €16,577/QALY gained, €2025/HZ case avoided, and €5594/PHN case avoided under the third-party payer perspective. From a societal perspective, the ICERs increased by 6%, due to the higher price of the vaccine. The number needed to vaccinate to prevent one case was 20 for HZ, and 63 for PHN3. Sensitivity analyses showed that the model was most sensitive to the HZ and PHN epidemiological data, the health state utilities values, and vaccine price used. Conclusion Considering an acceptable range of cost-effectiveness of €30,000-€50,000 per QALY gained, vaccination of the 50+ population in Spain against HZ with a new vaccine, Zostavax, is cost-effective and makes good use of the valuable healthcare budget.
authors.affiliation: a Sanofi Pasteur MSD , Madrid , Spain ;
authors.forename: Juan Luis
authors.initials: JL
authors.lastname: Lopez-Belmonte
authors.affiliation: b Clinical Microbiology and Infection Control OSI Bilbao Basurto , UPV/EHU Bilbao , Spain ;
authors.forename: Ramón
authors.initials: R
authors.lastname: Cisterna
authors.affiliation: c Health Sciences and Public Healthcare Department , Universidad Rey Juan Carlos , Madrid , Spain ;
authors.forename: Angel
authors.initials: A
authors.lastname: Gil de Miguel
authors.affiliation: d Mapi Group , Nanterre , France ;
authors.forename: Caroline
authors.initials: C
authors.lastname: Guilmet
authors.affiliation: d Mapi Group , Nanterre , France ;
authors.forename: Florence
authors.initials: F
authors.lastname: Bianic
authors.affiliation: e Sanofi Pasteur MSD , Lyon , France.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Uhart
mesh_terms: D000367:Age Factors; D000368:Aged; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D006562:Herpes Zoster / Q000517:prevention & control*; D053061:Herpes Zoster Vaccine / Q000008:administration & dosage* / Q000191:economics*; D006801:Humans; D015994:Incidence; D007349:Insurance, Health, Reimbursement; D008875:Middle Aged; D017059:Models, Econometric; D051474:Neuralgia, Postherpetic / Q000517:prevention & control*; D019057:Quality-Adjusted Life Years; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D013030:Spain
chemical_list: D053061:Herpes Zoster Vaccine
keywords: 50 years; Cost-effectiveness; Spain; VZV; Vaccination; Zostavax