Table 4C.
One-Way Sensitivity Analysis (Impact on ICER for Those Vaccinated at Age 70)
| Variable | Base Case Value | Range (Low–High) | ICER of AV vs NoV (Low) | ICER of LAV vs NoV (High) | ICER of SUV vs NoV (Low) | ICER of SUV vs NoV (High) |
|---|---|---|---|---|---|---|
| HZ incidence per 1000 person-years | ||||||
| 70–79 y | 12.02 | 11.79 to 12.25 | $92 457 | $84 319 | $2149 | $697 |
| 80–100 y | 12.78 | 12.49 to 13.07 | $88 251 | $88 251 | $1559 | $1257 |
| Complications given HZ, % | ||||||
| Probability of ocular complications | ||||||
| 70–79 y | 0.05 | 0.03 to 0.07 | $88 251 | $88 251 | $1407 | $1407 |
| 80–100 y | 0.07 | 0.05 to 0.09 | $88 251 | $88 251 | $1407 | $1407 |
| PHN by age | ||||||
| 70–100 y | 0.185 | 0.142 to 0.228 | $125 194 | $66 297 | $6394 | Cost-saving |
| Probability of moderate or severe PHN | ||||||
| 70–79 y | 0.61 | 0.51 to 0.71 | $99 717 | $79 072 | $1800 | $1066 |
| 80–84 y | 0.65 | 0.55 to 0.75 | $88 251 | $88 251 | $1465 | $1351 |
| 85–100 y | 0.68 | 0.58 to 0.78 | $88 251 | $88 251 | $1414 | $1401 |
| Probability of moderate PHN in individuals with moderate or severe PHN | 0.5 | 0.03 to 0.08 | $79 649 | $105 022 | $953 | $2235 |
| Probability of pain given HZ | ||||||
| No pain given HZ | 0.05 | 0.00 to 0.27 | $89 400 | $83 536 | $1405 | $1420 |
| Mild pain given HZ | 0.11 | 0.04 to 0.43 | $91 716 | $75 425 | $1448 | $1251 |
| Moderate pain given HZ | 0.37 | 0.19 to 0.57 | $92 750 | $83 277 | $1958 | $784 |
| Severe pain given HZ | 0.47 | 0.26 to 0.63 | $94 971 | $81 042 | $2885 | Cost-saving |
| Death due to HZ per 100 000 | ||||||
| 70–79 y | 6.18 | 5.32 to 7.03 | $88 352 | $88 153 | $1408 | $1407 |
| 80–89 y | 23.96 | 21.88 to 26.03 | $88 251 | $88 251 | $1408 | $1407 |
| 90–100 y | 152.13 | 143.76 to 160.5 | $88 251 | $88 251 | $1407 | $1407 |
| Vaccination efficacy and adverse events | ||||||
| LAV | ||||||
| 70–79 y | 0.407 | 0.285 to 0.529 | $616 280 | $27 345 | $1407 | $1407 |
| LAV waning rate | –0.0544 | –0.072 to –0.037 | $147 990 | $44 236 | $1407 | $1407 |
| SUV | ||||||
| Aged 70–79 y | 0.899 | 0.846 to 0.937 | $88 251 | $88 251 | $6236 | Cost-saving |
| SUV waning rate | –0.0544 | –0.072 to –0.037 | $88 251 | $88 251 | $11 242 | Cost-saving |
| Adverse events above placebo | ||||||
| LAV injection site reaction | 0.317 | 0.283 to 0.326 | $88 251 | $88 251 | $1407 | $1407 |
| LAV serious adverse event | 0.001 | 0 to 0.002 | $88 251 | $88 251 | $1407 | $1407 |
| SUV injection site reaction | 0.669 | 0.6021 to 0.7359 | $88 251 | $88 251 | $1367 | $1451 |
| SUV serious adverse event | 0.00058 | 0 to 0.003 | $88 251 | $88 251 | $1385 | $1501 |
| Utilities | ||||||
| Acute HZ QALYs lost | ||||||
| No pain HZ | 0.02 | 0.014 to 0.026 | $88 599 | $87 906 | $1412 | $1403 |
| Mild HZ | 0.041 | 0.029 to 0.053 | $89 906 | $86 656 | $1427 | $1389 |
| Moderate HZ | 0.047 | 0.033 to 0.061 | $94 620 | $82 686 | $1481 | $1341 |
| Severe HZ | 0.058 | 0.040 to 0.075 | $98 695 | $79 806 | $1527 | $1306 |
| PHN QALYs lost | ||||||
| Mild pain PHN | 0.31 | 0.211 to 0.433 | $93 114 | $82 874 | $1463 | $1344 |
| Moderate pain PHN | 0.55 | 0.389 to 0.731 | $97 963 | $79 402 | $1520 | $1300 |
| Severe pain PHN | 0.77 | 0.498 to 0.992 | $111 620 | $75 372 | $1668 | $1249 |
| Ocular complications QALYs lost | 0.24 | 0.178 to 0.311 | $88 251 | $88 251 | $1407 | $1407 |
| Adverse reactions and adverse events | ||||||
| Common AR QALYs lost per dose | 0.001 | 0.0005 to 0.002 | $64 445 | $337 906 | $1225 | $2007 |
| Serious AE QALYs lost per dose | 0.0000213 | 6.4E-06 to 4.6E-05 | $87 291 | $89 871 | $1406 | $1410 |
| Costs | ||||||
| LAV | $134.16 | $100.62 to $167.70 | $56 744 | $119 758 | $1407 | $1407 |
| SUV | $204.38 | $153.29 to $255.48 | $88 251 | $88 251 | Cost-saving | $10 609 |
| Vaccine administration cost (HCPCS 90471) | $20.88 | $15.66 to $26.10 | $83 348 | $93 155 | Cost-saving | $3245 |
| Direct medical costs, $/case, adjusted for inflation | ||||||
| Acute HZ | $957 | $867 to $1151 | $89 834 | $86 599 | $2582 | $180 |
| PHN | $5831 | $4055 to $7936 | $94 028 | $81 404 | $5696 | -$3676 |
| Ocular complications | $4163 | $2986 to $5543 | $88 251 | $88 251 | $1407 | $1407 |
| Serious adverse event, $/vaccine dose | $0.18 | $0.11 to $0.25 | $88 185 | $88 317 | $1400 | $1415 |
| Productivity costs HZ, h | ||||||
| No pain HZ | 5 | 3 to 5 | $88 296 | $88 229 | $1440 | $1391 |
| Mild | 6 | 4 to 8 | $89 093 | $87 410 | $2033 | $782 |
| Moderate HZ | 22 | 15 to 30 | $89 392 | $86 948 | $2255 | $439 |
| Severe HZ | 61 | 39 to 82 | $92 815 | $83 895 | $4796 | Cost-saving |
| Mild pain, PHN | 4 | 3 to 5 | $88 283 | $88 219 | $1431 | $1384 |
| Moderate pain, PHN | 30 | 20 to 41 | $88 501 | $87 976 | $1595 | $1201 |
| Severe pain, PHN | 81 | 53 to 110 | $88 951 | $87 526 | $1933 | $864 |
| Average hourly wages | $26.61 | $19.96 to $33.26 | $93 694 | $82 809 | $5453 | Cost-saving |
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.