Methods: To estimate the relative cost-effectiveness of SUV, LAV and no vaccination (NV) strategies, a Markov model was developed based on published trials and data on vaccine efficacy persistence, quality of life, resource utilization, costs and disease epidemiology. The perspective was U.S. societal, and the cycle length was one year with a lifelong time horizon. SUV efficacy was estimated for the base case to wane at the same rate as LAV, all persons were assumed to receive both doses of SUV, and the cost of SUV included both doses.
Results: For individuals vaccinated at age 50 years the incremental cost-effectiveness ratio (ICER) for LAV vs NV was $142,811 per quality-adjusted life-year (QALY); at age 60 years the ICER dropped to $59,482 per QALY. The cost-effectiveness ratio of SUV approached that of LAV when the SUV cost approached $500 for persons vaccinated at age 50 years and when the cost was $400 for those vaccinated at age 60 years. The SUV cost that would result in achieving an ICER target of $100,000 per QALY for SUV vaccination versus NV at age 50 years was $316; at age 60 years the cost was $638.
Conclusion: Vaccination at age 60 years with SUV was more cost-effective than LAV when SUV cost was ~$450 or less. Vaccination with SUV at age 50 years appeared to be cost-effective if SUV cost was ~$315 or less.
J. Stassinopoulos, None
G. Pisacreta, None
D. Hutton, None