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Background <p>Many studies of the adjuvanted recombinant zoster vaccine (RZV) consider it cost-effective using efficacy estimates from randomized trials (RCTs). However, the effect magnitude differs between RCTs and observational studies, in addition to other input parameters that have shown to greatly impact cost-effectiveness. The aim of the current study is to assess the economic case of the RZV in Sweden and assess at which price the vaccine would be considered cost-effective.</p> Methods <p>A decision-analytic model was used to estimate the health economic impact of introducing RZV in Sweden. Five-year age-cohorts were modelled between ages 65 to 100+, comparing the cost-effectiveness of two-dose RZV to no vaccination from a health care perspective, using efficacy data from RCTs and observational estimates. The model was run over a lifetime time horizon with quality adjusted life years (QALYs) as the outcome. Multiple one-way and probabilistic sensitivity analyses were conducted to analyze the impact of parameter uncertainty.</p> Results <p>At a willingness-to-pay of 80,000 Euro per QALY, the RZV was cost-effective across cohorts at a price per dose of 80 to 105 Euro in basecase analyses, in contrast to the current market price at 176 Euro. However, due to parameter uncertainty, the price per dose at which the RZV may be considered cost-effective varies between as high as the current market price to less than 10% of that price, depending on which input variables are used.</p> Conclusion <p>The price at which the RZV would be considered cost-effective varies greatly, highlighting the need to explore and consider parameter uncertainty in both analyses and procurement negotiations.</p>

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Informing decisions in light of parameter uncertainty – an economic evaluation of the adjuvanted recombinant herpes zoster vaccine in Sweden

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月14日

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  • Camilla Nystrand,
  • Katarina Widgren,
  • Shuang Hao,
  • Emelie Heintz,
  • Vibeke Sparring

摘要

Background

Many studies of the adjuvanted recombinant zoster vaccine (RZV) consider it cost-effective using efficacy estimates from randomized trials (RCTs). However, the effect magnitude differs between RCTs and observational studies, in addition to other input parameters that have shown to greatly impact cost-effectiveness. The aim of the current study is to assess the economic case of the RZV in Sweden and assess at which price the vaccine would be considered cost-effective.

Methods

A decision-analytic model was used to estimate the health economic impact of introducing RZV in Sweden. Five-year age-cohorts were modelled between ages 65 to 100+, comparing the cost-effectiveness of two-dose RZV to no vaccination from a health care perspective, using efficacy data from RCTs and observational estimates. The model was run over a lifetime time horizon with quality adjusted life years (QALYs) as the outcome. Multiple one-way and probabilistic sensitivity analyses were conducted to analyze the impact of parameter uncertainty.

Results

At a willingness-to-pay of 80,000 Euro per QALY, the RZV was cost-effective across cohorts at a price per dose of 80 to 105 Euro in basecase analyses, in contrast to the current market price at 176 Euro. However, due to parameter uncertainty, the price per dose at which the RZV may be considered cost-effective varies between as high as the current market price to less than 10% of that price, depending on which input variables are used.

Conclusion

The price at which the RZV would be considered cost-effective varies greatly, highlighting the need to explore and consider parameter uncertainty in both analyses and procurement negotiations.