Unlocking herpes zoster vaccination value in Finland: return on investment and actuarial model
摘要
Herpes zoster (HZ) is common in Finland, leading to long-term postherpetic neuralgia (PHN) especially with ageing. HZ reduces productivity, placing an economic burden on society. An integrated actuarial and macroeconomic model assessed the return on investment of recombinant zoster vaccine (RZV) in Finland for adults ≥ 50 years versus no vaccination.
MethodsA validated economic model determined HZ cases and complications avoided, health gains (quality-adjusted life-years, QALYs), and healthcare cost-savings. Actuarial techniques projected population trends incorporating employment factors. Lost productivity averted through vaccination provided fiscal revenue for the government, and increased gross domestic product (GDP) for society. QALY gains were monetised using 1–3xGDP per QALY. RZV was administered for 20 years, with lifetime impact assessment.
ResultsRZV vaccination of around 790,000 50year-olds was estimated to save 3,779 QALYs and €52 million (M) in healthcare costs. Averted productivity losses generated €152 M in fiscal revenue and €367 M in GDP, while vaccination costs were €236 M. From the fiscal perspective, 90% of vaccination costs were offset by fiscal and healthcare cost savings (without considering QALY gains). From the societal perspective, for every €1 invested in vaccination, €2.60–4.10 was saved (depending on QALY value). The benefit-cost ratio (BCR) remained positive across sensitivity analyses. The highest BCRs were achieved when vaccinating adults aged 50 years; or 65 years when excluding productivity benefits.
ConclusionRZV vaccination in working-age adults yielded economic benefits in Finland, generating €2.60–4.10 for society per €1 invested in vaccination, and with fiscal benefits offsetting 90% of vaccination costs.