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Cost effectiveness of the adjuvanted recombinant zoster vaccine in older adults in Portugal

2026Artigo científico Acesso aberto
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dc.contributor.authorZarkadoulas, Eleftherios
dc.contributor.authorSilva, Fábio
dc.contributor.authorAlves, Joana
dc.contributor.authorMadeira, Francisco
dc.contributor.authorPostma, Maarten J.
dc.contributor.institutionLaboratório Associado de Translacção e Inovação para a Saúde Global - LA Real (Pólo ENSP)
dc.contributor.institutionComprehensive Health Research Centre (CHRC) - Pólo ENSP
dc.contributor.institutionCentro de Investigação em Saúde Pública (CISP/PHRC)
dc.contributor.institutionEscola Nacional de Saúde Pública (ENSP)
dc.contributor.pblAdis
dc.date.accessioned2026-05-21T10:00:02Z
dc.date.available2026-05-21T10:00:02Z
dc.date.issued2026
dc.descriptionPublisher Copyright: © GlaxoSmithKline Biologicals SA 2026.
dc.description.abstractBackground and objectives: Herpes zoster (HZ) and associated complications comprise a considerable public health burden in older adults. This study aimed to evaluate the cost-effectiveness of recombinant zoster vaccine (RZV) versus no vaccine for the prevention of HZ in older adults in Portugal. Methods: A static multicohort Markov model (ZONA) was adapted to the Portuguese context. The base-case compared RZV with no vaccination in a hypothetical cohort of 1 million adults aged ≥65 years. Real-world data were used for first-dose coverage (56.1%) and second-dose completion (67.2%), with vaccine efficacy and waning based on 11-year follow-up data. Outcomes were calculated over a lifetime horizon from the societal perspective, with a 4% discount applied to costs and quality-adjusted life years (QALYs). In the base-case, HZ incidence was based on previously reported European data. Sensitivity analyses were performed, and a scenario analysis explored the impact of alternative HZ incidence rates based on recent Portuguese data. Results: Over a lifetime horizon, RZV was estimated to prevent 45,551 HZ cases, 9056 post-herpetic neuralgia (PHN) cases, 5580 cases with other non-PHN complications, and 6 HZ deaths. The incremental cost-effectiveness ratio (ICER) from the societal perspective was €48,707 per QALY gained, below a hypothetical willingness-to-pay threshold of two times the gross domestic product per capita per QALY gained (equivalent to €62,200). This base-case ICER was most sensitive to the annual incidence of initial HZ. In the scenario analysis, exploring higher HZ incidence based on Portuguese data, the estimated ICER was €41,877 per QALY gained. In both the base-case and the scenario analyses, ICERs were lowest in individuals aged 65–69 years, with ICERs ranging from €36,207 to €42,700 per QALY gained, in the scenario analysis and base case, respectively. Conclusions: RZV presents a cost-effective option for the prevention of HZ and its complications in Portuguese adults aged ≥ 65 years, with greater cost effectiveness in those aged 65–69 years.en
dc.description.versionpublishersversion
dc.description.versioninpress
dc.format.extent2358458
dc.identifier.doi10.1007/s41669-026-00640-3
dc.identifier.issn2509-4262
dc.identifier.otherPURE: 163308622
dc.identifier.otherPURE UUID: 4263bf98-c823-4c2b-96ca-e17d14d9ba37
dc.identifier.otherScopus: 105032121977
dc.identifier.otherWOS: 001704192800001
dc.identifier.otherPubMed: 41772293
dc.identifier.urihttp://hdl.handle.net/10362/203261
dc.identifier.urlhttps://www.scopus.com/pages/publications/105032121977
dc.language.isoeng
dc.peerreviewedyes
dc.subjectPharmacology
dc.subjectHealth Policy
dc.subjectPharmacology (medical)
dc.subjectSDG 3 - Good Health and Well-being
dc.titleCost effectiveness of the adjuvanted recombinant zoster vaccine in older adults in Portugalen
dc.typejournal article
degois.publication.titlePharmacoEconomics - Open
dspace.entity.typePublication
rcaap.rightsopenAccess

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