Table 4B.
One-Way Sensitivity Analysis (Impact on ICER for Those Vaccinated at Age 60)
| Variable | Base Case Value | Range (Low–High) | ICER of AV vs NoV (Low) | ICER of AV vs NoV (High) | ICER of UV vs NoV (Low) | ICER of UV vs NoV (High) |
|---|---|---|---|---|---|---|
| HZ incidence per 1000 person-years | ||||||
| 60–69 y | 9.32 | 9.20 to 9.44 | $44 209 | $41 269 | $20 125 | $18 498 |
| 70–79 y | 12.02 | 11.79 to 12.25 | $42 980 | $42 447 | $19 795 | $18 814 |
| 80–100 y | 12.78 | 12.49 to 13.07 | $42 712 | $42 712 | $19 300 | $19 300 |
| Complications given HZ, % | ||||||
| Probability of ocular complications | ||||||
| 60–69 y | 0.04 | 0.02 to 0.06 | $42 712 | $42 712 | $19 300 | $19 300 |
| 70–79 y | 0.05 | 0.03 to 0.07 | $42 712 | $42 712 | $19 300 | $19 300 |
| 80–100 y | 0.07 | 0.05 to 0.09 | $42 712 | $42 712 | $19 300 | $19 300 |
| PHN by age | ||||||
| 60–69 y | 0.069 | 0.042 to 0.096 | $58 423 | $32 254 | $26 478 | $14 048 |
| 70–100 y | 0.185 | 0.142 to 0.228 | $44 435 | $41 080 | $22 318 | $16 684 |
| Probability of moderate or severe PHN | ||||||
| 60–69 y | 0.56 | 0.46 to 0.66 | $45 391 | $40 311 | $20 310 | $18 372 |
| 70–79 y | 0.61 | 0.51 to 0.71 | $43 260 | $42 177 | $20 041 | $18 604 |
| 80–84 y | 0.65 | 0.55 to 0.75 | $42 712 | $42 712 | $19 300 | $19 300 |
| 85–100 y | 0.68 | 0.58 to 0.78 | $42 712 | $42 712 | $19 300 | $19 300 |
| Probability of moderate PHN in individuals with moderate or severe PHN | 0.5 | 0.03 to 0.08 | $40 162 | $47 132 | $17 845 | $21 870 |
| Probability of pain given HZ | ||||||
| No pain given HZ | 0.05 | 0.00 to 0.27 | $43 496 | $39 588 | $19 606 | $18 067 |
| Mild pain given HZ | 0.11 | 0.04 to 0.43 | $45 148 | $34 366 | $20 298 | $15 802 |
| Moderate pain given HZ | 0.37 | 0.19 to 0.57 | $46 355 | $38 839 | $21 275 | $17 176 |
| Severe pain given HZ | 0.47 | 0.26 to 0.63 | $48 808 | $36 480 | $23 157 | $15 299 |
| Death due to HZ per 100 000 | ||||||
| 60–69 y | 2.22 | 1.72 to 2.72 | $42 712 | $42 712 | $19 300 | $19 300 |
| 70–79 y | 6.18 | 5.32 to 7.03 | $42 762 | $42 663 | $19 317 | $19 283 |
| 80–89 y | 23.96 | 21.88 to 26.03 | $42 718 | $42 707 | $19 306 | $19 294 |
| 90–100 y | 152.13 | 143.76 to 160.5 | $42 712 | $42 712 | $19 300 | $19 300 |
| Vaccination efficacy and adverse events | ||||||
| LAV | ||||||
| 60–69 y | 0.657 | 0.460 to 0.854 | $334 733 | $682 | $19 300 | $19 300 |
| LAV waning rate | –0.0544 | –0.072 to –0.037 | $90 956 | $8690 | $19 300 | $19 300 |
| SUV | ||||||
| Aged 60–69 y | 0.941 | 0.856 to 0.981 | $42 712 | $42 712 | $40 084 | $12 720 |
| SUV waning rate | –0.0544 | –0.072 to –0.037 | $42 712 | $42 712 | $55 082 | Cost-saving |
| Adverse events above placebo | ||||||
| LAV injection site reaction | 0.317 | 0.283 to 0.326 | $42 712 | $42 712 | $19 300 | $19 300 |
| LAV serious adverse event | 0.001 | 0 to 0.002 | $42 712 | $42 712 | $19 300 | $19 300 |
| SUV injection site reaction | 0.669 | 0.6021 to 0.7359 | $42 712 | $42 712 | $18 286 | $20 432 |
| SUV serious adverse event | 0.00058 | 0 to 0.003 | $42 712 | $42 712 | $19 203 | $19 714 |
| Utilities | ||||||
| Acute HZ QALYs lost | ||||||
| No pain HZ | 0.02 | 0.014 to 0.026 | $42 953 | $42 474 | $19 399 | $19 202 |
| Mild HZ | 0.041 | 0.029 to 0.053 | $43 865 | $41 619 | $19 774 | $18 848 |
| Moderate HZ | 0.047 | 0.033 to 0.061 | $47 255 | $38 967 | $21 153 | $17 745 |
| Severe HZ | 0.058 | 0.040 to 0.075 | $50 316 | $37 105 | $22 383 | $16 963 |
| PHN QALYs lost | ||||||
| Mild pain PHN | 0.31 | 0.211 to 0.433 | $44 242 | $40 954 | $20 043 | $18 450 |
| Moderate pain PHN | 0.55 | 0.389 to 0.731 | $45 214 | $40 211 | $20 586 | $18 033 |
| Severe pain PHN | 0.77 | 0.498 to 0.992 | $48 363 | $38 994 | $22 233 | $17 424 |
| Ocular complications QALYs lost | 0.24 | 0.178 to 0.311 | $42 712 | $42 712 | $19 300 | $19 300 |
| Adverse reactions and adverse events | ||||||
| Common AR QALYs lost per dose | 0.001 | 0.0005 to 0.002 | $33 464 | $95 504 | $15 112 | $43 299 |
| Serious AE QALYs lost per dose | 0.0000213 | 6.4E-06 to 4.6E-05 | $42 364 | $43 296 | $19 257 | $19 371 |
| Costs | ||||||
| LAV | $134.16 | $100.62 to $167.70 | $20 253 | $65 171 | $19 300 | $19 300 |
| SUV | $204.38 | $153.29 to $255.48 | $42 712 | $42 712 | $3046 | $35 557 |
| Vaccine administration cost (HCPCS 90471) | $20.88 | $15.66 to $26.10 | $39 217 | $46 208 | $16 053 | $22 547 |
| Direct medical costs, $/case, adjusted for inflation | ||||||
| Acute HZ | $957 | $867 to $1151 | $44 873 | $40 455 | $21 283 | $17 228 |
| PHN | $5831 | $4055 to $7936 | $46 035 | $38 774 | $23 017 | $14 895 |
| Ocular complications | $4163 | $2986 to $5543 | $42 712 | $42 712 | $19 300 | $19 300 |
| Serious adverse event, $/vaccine dose | $0.18 | $0.11 to $0.25 | $42 666 | $42 759 | $19 287 | $19 313 |
| Productivity costs HZ, h | ||||||
| No pain HZ | 5 | 3 to 5 | $42 773 | $42 682 | $19 356 | $19 272 |
| Mild | 6 | 4 to 8 | $43 862 | $41 563 | $20 355 | $18 245 |
| Moderate HZ | 22 | 15 to 30 | $44 270 | $40 932 | $20 730 | $17 666 |
| Severe HZ | 61 | 39 to 82 | $48 944 | $36 764 | $25 020 | $13 840 |
| Mild pain, PHN | 4 | 3 to 5 | $42 733 | $42 692 | $19 322 | $19 278 |
| Moderate pain, PHN | 30 | 20 to 41 | $42 847 | $42 565 | $19 453 | $19 131 |
| Severe pain, PHN | 81 | 53 to 110 | $43 088 | $42 323 | $19 730 | $18 855 |
| Average hourly wages | $26.61 | $19.96 to $33.26 | $49 546 | $35 879 | $25 660 | $12 940 |
Abbreviations: AE, adverse event; AR, adverse reaction; HCPCS, Healthcare Common Procedure Coding System; HZ, herpes zoster; ICER, incremental cost-effectiveness ratio; LAV, live attenuated HZ vaccine; NoV, no vaccine; PHN, post-herpetic neuralgia; QALY, quality-adjusted life-year, SUV, subunit vaccine.