Adjuvanted shingles subunit vaccine likely more cost-effective

(HealthDay)—The new adjuvanted herpes zoster subunit vaccine (HZ/su) is cost-effective compared with the currently recommended live attenuated herpes zoster vaccine (ZVL), according to a study published online Jan. 2 in JAMA Internal Medicine.

Phuc Le, Ph.D., M.P.H., and Michael B. Rothberg, M.D., M.P.H., both from the Cleveland Clinic, assessed the cost-effectiveness of HZ/su among immunocompetent adults aged 60 years or older. The model included scenarios for no vaccination, ZVL (single dose) vaccine, and HZ/su (two-dose series) vaccine administered at different ages.

Based on randomized clinical trial data, the researchers found that at a price of $280 per the two-dose series, HZ/su was more effective and less expensive than ZVL at all ages. Compared with no vaccination, the incremental cost-effectiveness ratios ranged from $20,038 to $30,084 per quality-adjusted life-year (QALY), depending on vaccination age. The findings were insensitive to variation other than in vaccine price and certain combinations of low adherence rate with a second dose and low efficacy of a single dose of HZ/su. HZ/su had lower overall costs than ZVL (at the current ZVL price of $213 per dose) up to a price of $350 per two-dose series.

"Under conservative assumptions, at a price of $280 per series ($140 per dose), HZ/su would cost less than ZVL and has a high probability of offering good value," the authors write.