Cost-effectiveness analysis of herpes zoster vaccine in adults above 50 in Singapore

Background/Objectives: Incidence of herpes zoster (HZ) increases with age. The vaccine to prevent HZ is available for those who are 50 and older. This study aims to investigate the cost-effectiveness of HZ vaccine on population older than 50 years old from a societal perspective in Singapore. Methods: The established decision analytic (Markov) model was utilized to simulate the results of vaccination for adults who were older than 50 years of age, compared to those without vaccination. The total number of HZ cases, postherpetic neuralgia (PHN) cases, total direct cost of treatment and indirect cost due to productivity loss were estimated based on the characteristics of population, and treatment costs were collected from a local institute in Singapore. The public health consensus for the ICER benchmark in Singapore was S$65,000. Results: One million individuals were simulated in this health economics analysis. Vaccination would reduce 48% of HZ cases and 33% of PHN cases over their life time. When a vaccination strategy for adults who are 50 years old and older was compared to a strategy with no vaccination, incremental cost-effectiveness ratio (ICER) was S$49,023 per quality adjusted life years (QALY) gained from the societal perspective. Conclusion: The herpes zoster vaccination is likely to be cost-effective in societal perspective for adult over 50 years of age in Singapore