Cost-Effectiveness Analysis of a Vaccination Programme for the Prevention of Herpes Zoster and Post-Herpetic Neuralgia in Adults Aged 50 and Over in Germany

A vaccine is licensed in Europe for the prevention of Herpes Zoster (HZ) and postherpetic neuralgia (PHN) in adults aged ≥50 years. The objective of this study was to assess the cost-effectiveness of a vaccination programme in Germany in this population. An existing European Markov Model was adapted to the German health care setting and cost-effectiveness outcomes were assessed from the statutory health insurance (SHI) and from the societal perspective. The Markov Model compares a HZ vaccination policy for adults aged ≥50 years with a no vaccination policy. Health states considered are healthy, HZ, PHN, healthy post-HZ and death. HZ and PHN states are further split by pain severity (mild, moderate or severe). Model outcomes include cost/HZ case avoided, cost/PHN case avoided and cost/quality-adjusted life year (QALY) gained. Additionally we assessed the number needed to vaccinate (NNV) to avoid one case of HZ or PHN. Input data were obtained from German data sources, international and German study results as well as published literature. Discounting was done in accordance to guidelines from the German Institute for Quality and Efficiency in Health Care (IQWiG). Preliminary results of the base-case analysis show incremental cost-effectiveness and cost-utility ratios (ICER) in amount of € 2,223 per HZ case avoided and € 22,923 per QALY gained from a payer perspective. In sensitivity analyses discount rates, vaccine prices and no hospitalization assumption showed a major impact on the results. Our cost-effectiveness analysis shows that a HZ vaccination policy for adults aged ≥50 years in Germany could provide public health and economic effects in the German health care system.