Information from the abstract
Background: Patients with end-stage renal disease (ESRD) are increased risk of herpes zoster (HZ). The economic value of HZ vaccines in Thai patients with ESRD has not been assessed. This study evaluated the cost-utility and budget impact of two HZ vaccination strategies - zoster vaccine live (ZVL) and recombinant zoster vaccine (RZV) - compared with no vaccination in Thailand. Methods: A Markov model was developed to estimate lifetime health and economic outcomes in patients with ESRD. Cost-utility analysis was conducted from a societal perspective, while budget impact analysis was performed from a payer perspective over a 5-year time horizon. Model inputs were derived from published literature and Thai data sources. Uncertainty was assessed using deterministic, probabilistic, and scenario sensitivity analyses. Results: In the base-case analysis, both ZVL and RZV were cost-effective compared with no vaccination, with incremental cost-effectiveness ratios (ICER) of USD 1,599.14 (THB 51,912.56) and USD 2,920.09 (THB 94,794.30) per quality-adjusted life year (QALY) gained, respectively - both below Thailand's willingness-to-pay threshold. RZV generated greater health benefits but was associated with higher costs. Sensitivity analyses confirmed the robustness of cost-effectiveness results across key assumptions. Over a 5-year period, the estimated budget impact ranged from USD 4.99-9.55 million (THB 161.86-310.02 million) for ZVL and USD 28.92-55.42 million (THB 938.95-1,799.09 million) for RZV, depending on vaccine uptake assumptions, with expenditures largely concentrated in the first year due to vaccination of prevalent patients. Conclusion: Both HZ vaccines are cost-effective options for preventing HZ in Thai patients with ESRD. While RZV provides greater health gains, it requires substantially higher budgetary investment. These findings support prioritising HZ vaccination for patients with ESRD and initiating pilot implementation within dialysis care settings to assess system-level impact and feasibility.
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This record has an Impact Signal of 85/100 based on recency, source, collaboration, and bibliographic signals. It prioritizes monitoring and is not a judgment of research quality.
Related topics: Herpesvirus Infections and Treatments · Virus-based gene therapy research · Cytomegalovirus and herpesvirus research
Thai researcher and institutional participation
Nattanichcha Kulthanachairojana · Pattheera Phothong · Pitch Promkladphanao · Chollakarn Singharerg · Jatapat Hemapanpairoa · Burapha University · Silpakorn University
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