New Shingles Vaccine Cost-Effective, Cost-Saving Compared With Zostavax

Research presented at the AMCP 2018 Annual Meeting found that Shingrix (non-live adjuvanted subunit vaccine; GlaxosmithKline) is cost-effective when compared with no vaccination and cost-saving compared with an older shingles vaccine.

In their presentation, Brandon J Patterson, PhD, PharmD, of US Health Outcomes and Epidemiology in Vaccines at GlaxoSmithKline, and colleagues, explained the burden of shingles. They also noted that there was previously only one vaccine on the market for prevention of the disease, Zostavax (zoster vaccine live; Merck). 

“Herpes zoster affects one in three adults in the United States over the course of their lifetimes,” Dr Patterson and colleagues wrote. “Herpes zoster is characterized by a highly painful rash and is associated with a substantial cost burden.”

To measure the cost-effectiveness of the new shingles vaccine, Shingrix, the researchers compared a model cohort of patients for two scenarios: no vaccination and vaccination with the older vaccine. The model cohorts included 1 million hypothetical patients aged older than 60 years, with annual vaccination cycles extrapolated for the average remaining life years. 

“The primary perspective was societal, including both direct medical costs and indirect costs,” the researchers wrote.

Study results showed that compared with the unvaccinated scenario, vaccination with Shingrix would add 2291 QALYs and reduce total societal medical costs by about $27 million. The incremental cost-effectiveness ratio for this scenario was $11,863.

Additionally, when compared with Zostavax vaccination, Shingrix reduced disease burden and added 1261 discounted QALYs. Furthermore, the researchers found this scenario saved $96 million overall. 

“For vaccinating US adults aged 60 and older who have not been previously vaccinated against herpes zoster, [Shingrix] is cost-effective relative to a no vaccination choice and cost-saving relative to a vaccination with [Zostavax] choice,” Dr Patterson and colleagues concluded. “These findings were robust as demonstrated by sensitivity, scenario, and threshold analyses.”

—David Costill