原创力文档assessing the potential effects and cost-effectiveness of programmatic herpes zoster vaccination of elderly in the netherlands评估项目的潜在影响和成本效益带状疱疹疫苗的老年人在荷兰.pdfVIP
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assessing the potential effects and cost-effectiveness of programmatic herpes zoster vaccination of elderly in the netherlands评估项目的潜在影响和成本效益带状疱疹疫苗的老年人在荷兰
van Lier et al. BMC Health Services Research 2010, 10:237
/1472-6963/10/237
RESEARCH ARTICLE Open Access
Assessing the potential effects and
cost-effectiveness of programmatic herpes
zoster vaccination of elderly in the Netherlands
1*† 2† 3 4 1
Alies van Lier , Albert Jan van Hoek , Wim Opstelten , Hein J Boot , Hester E de Melker
Abstract
Background: Herpes zoster (HZ) is a painful disease affecting a considerable part of the elderly. Programmatic HZ
vaccination of elderly people may considerably reduce HZ morbidity and its related costs, but the extent of these
effects is unknown. In this article, the potential effects and cost-effectiveness of programmatic HZ vaccination of
elderly in the Netherlands have been assessed according to a framework that was developed to support evidence-
based decision making regarding inclusion of new vaccines in the Dutch National Immunization Program.
Methods: An analytical framework was used combining a checklist, which structured relevant data on the vaccine,
pathogen and disease, and a cost-effectiveness analysis. The cost-effectiveness analysis was performed from a
societal perspective, using a Markov-cohort-model. Simultaneous vaccination with influenza was assumed.
Results: Due to the combination of waning immunity after vaccination and a reduced efficacy of vaccination at
high ages, the most optimal cost-effectiveness ratio (€21716 per QALY) for HZ vaccination in the Netherlands was
found for 70-year olds. This estimated ratio is just above the socially accepted threshold in the Netherlands of
€20000 per QALY. If additional reduction of postherpetic neuralgia was included, the cost-effectiveness ratio
improved (~€ 10000 per QALY) but uncertainty for this scenario is
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