Evaluation of the cost-effectiveness in the United States of a vaccine to prevent herpes zoster and postherpetic neuralgia in older adults

Vaccine ◽  
2007 ◽  
Vol 25 (49) ◽  
pp. 8326-8337 ◽  
Author(s):  
James M. Pellissier ◽  
Marc Brisson ◽  
Myron J. Levin
Keyword(s):  
United States ◽  
Older Adults ◽  
Herpes Zoster ◽  
Cost Effectiveness ◽  
Postherpetic Neuralgia ◽  
The United States ◽  
The Cost

scholarly journals Cost-effectiveness analysis of BNT162b2 COVID-19 booster vaccination in the United States

2021 ◽  
Author(s):  
Rui Li ◽  
Hanting Liu ◽  
Christopher Kit Fairley ◽  
Zhuoru Zou ◽  
Li Xie ◽  
...  
Keyword(s):  
United States ◽  
Older Adults ◽  
Cost Effectiveness ◽  
Booster Vaccination ◽  
Cost Effective ◽  
The United States ◽  
Cost Ratio ◽  
System Perspective ◽  
Benefit Cost Ratio ◽  
The Cost

Background: Over 86% of older adults aged ≥65 years are fully vaccinated against SARS-COV-2 in the United States (US). Waning protection of the existing vaccines promotes the new vaccination strategies, such as providing a booster shot for those fully vaccinated. Methods: We developed a decision-analytic Markov model of COVID-19 to evaluate the cost-effectiveness of a booster strategy of Pfizer-BioNTech BNT162b2 (administered 6 months after 2nd dose) in those aged ≥65 years, from a healthcare system perspective. Findings: Compared with 2-doses of BNT162b2 without a booster, the booster strategy in a 100,000 cohort of older adults would incur an additional cost of $3.4 million, but save $6.7 million in direct medical costs in 180 days. This corresponds to a benefit-cost ratio of 1.95 and a net monetary benefit of $3.4 million. Probabilistic sensitivity analysis indicates that with a COVID-19 incidence of 9.1/100,000 person-day, a booster strategy has a high chance (67%) of being cost-effective. The cost-effectiveness of the booster strategy is highly sensitive to the population incidence of COVID-19, with a cost-effectiveness threshold of 8.1/100,000 person-day. This threshold will increase with a decrease in vaccine and booster efficacies. Doubling the vaccination cost or halving the medical cost for COVID-19 treatment alone would not alter the conclusion of cost-effectiveness, but certain combinations of the two might render the booster strategy not cost-effective. Interpretation: Offering BNT162b2 boosters to older adults aged ≥65 years in the US is likely to be cost-effective. Less efficacious vaccines and boosters may still be cost-effective in settings of high SARS-COV-2 transmission. Funding: National Natural Science Foundation of China. Berlina and Bill Gates Foundation

The Epidemiology of Herpes Zoster in the United States During the Era of Varicella and Herpes Zoster Vaccines: Changing Patterns Among Older Adults

2018 ◽  
Vol 69 (2) ◽  
pp. 341-344 ◽  
Author(s):  
Rafael Harpaz ◽  
Jessica W Leung
Keyword(s):  
United States ◽  
Older Adults ◽  
Herpes Zoster ◽  
The United States ◽  
Administrative Databases ◽  
Younger Adults ◽  
Incidence Trends ◽  
Changing Patterns ◽  
Herpes Zoster Incidence

Abstract Historic herpes zoster incidence trends in US adults have been hard to interpret. Using administrative databases, we extended previous descriptions of these trends through 2016. We observed an age-specific transition, with ongoing increases among younger adults but deceleration in older adults. The patterns are not readily explained.

Estimating the Cost-Effectiveness of OnabotulinumtoxinA for Neurogenic Detrusor Overactivity in the United States

2013 ◽  
Vol 35 (4) ◽  
pp. 414-424 ◽  
Author(s):  
Josh J. Carlson ◽  
Ryan N. Hansen ◽  
Roger R. Dmochowski ◽  
Denise R. Globe ◽  
Danielle C. Colayco ◽  
...  
Keyword(s):  
United States ◽  
Cost Effectiveness ◽  
Detrusor Overactivity ◽  
The United States ◽  
Neurogenic Detrusor Overactivity ◽  
The Cost

scholarly journals The Cost-Effectiveness of Epilepsy Surgery and Surgical Evaluation in the United States

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Shehryar R Sheikh ◽  
Michael P Steinmetz ◽  
Michael W Kattan ◽  
Mendel Singer ◽  
Belinda Udeh ◽  
...  
Keyword(s):  
United States ◽  
Monte Carlo ◽  
Cost Effectiveness ◽  
Epilepsy Surgery ◽  
Medical Management ◽  
Cost Effective ◽  
The United States ◽  
Effective Strategies ◽  
Surgical Evaluation ◽  
The Cost

Abstract INTRODUCTION Surgery is an effective treatment for many pharmacoresistant temporal lobe epilepsy patients, but incurs considerable cost. It is unknown whether surgery and surgical evaluation are cost-effective strategies in the United States. We aim to evaluate whether 1) surgery is cost-effective for patients who have been deemed surgical candidates when compared to continued medical management, 2) surgical evaluation is cost-effective for patients who have drug-resistant temporal epilepsy and may or may not ultimately be deemed surgical candidates METHODS We use a Monte Carlo simulation method to assess the cost-effectiveness of surgery and surgical evaluation over a lifetime horizon. Patients transition between two health states (‘seizure free’ and ‘having seizures’) as part of a Markov process, based on literature estimates. We adopt both healthcare and societal perspectives, including direct healthcare costs and indirect costs such as lost earnings by patients and care providers. We estimate variability of model predictions using probabilistic and deterministic sensitivity analyses. RESULTS 1) Epilepsy surgery is cost effective in surgically eligible patients by virtue of being cost saving and more effective than medical management in the long run, with 95% of 10 000 Monte Carlo simulations favoring surgery. From a societal perspective, surgery becomes cost effective within 3 yr. At 5 yr, surgery has an incremental cost-effectiveness ratio (ICER) of $31,600, which is significantly below the societal willingness-to-pay (∼ $100,000/quality-adjusted life years (QALY)) and comparable to hip/knee arthroplasty. 2) Surgical evaluation is cost-effective in pharmacoresistant patients even if the probability of being deemed a surgical candidate is low (5%-10%). Even if the probability of surgical eligibility is only 10%, surgical referral has an ICER of $96,000/QALY, which is below societal willingness-to-pay. CONCLUSION Epilepsy surgery and surgical evaluation are both cost-effective strategies in the United States. Pharmacoresistant temporal lobe epilepsy patients should be referred for surgical evaluation without hesitation on cost-effectiveness grounds.

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