Shingles Vaccine Not Cost-Effective for Adults in Their 50's

Herpes zoster, otherwise known as shingles, causes a painful rash that can lead to additional complications. Although the condition is preventable with a vaccine, new research indicates that the vaccine is not worth it from an economic standpoint for certain patient groups.

The shingles vaccines is approved for adults ages 50 and older by the Food and Drug Administration (FDA). However, since there are no long-term studies identifying the benefits and risk for ages 50 to 59, the Centers for Disease Control and Prevention (CDC) recommends the vaccine for those ages 60 and older. Researchers from the Cleveland Clinic tallied how cost-effective the vaccine actually is in the Annals of Internal Medicine.

Postherpetic neuralgia (PHN) is a complication of shingles which harms nerve fibers and can cause severe burning pain. Using the Markov model, the researchers measured how effective the vaccine is for those in their 50’s. For every 1,000 people receiving the vaccine at age 50, only 25 cases of shingles would be prevented and one case of PHN. They went on to calculate the incremental cost-effectiveness ratio (ICER) between the vaccine and no vaccine, which came in at $323,456 per quality-adjusted life-year (QALY).

“In deterministic and scenario sensitivity analyses, the only variables that produced an ICER less than $100,000 per QALY were vaccine cost (at a value of $80) and the rate at which efficacy wanes,” the researchers explained. “In probabilistic sensitivity analysis, the mean ICER was $500,754 per QALY (95% CI, $93,510 to $1,691,211 per QALY).”

Further calculations revealed that there is only a probability of 3% that the vaccination would be cost-effective at the willingness-to-pay threshold of $100,000 per QALY.

“Herpes zoster vaccine for persons aged 50 years does not seem to represent good value according to generally accepted standards,” the authors confirmed.