It is cost effective to delay the shingles vaccine to age 60 rather than giving it at age 50, according to a new study in the Annals of Internal Medicine. The FDA has approved the vaccine to be given at age 50; however, the ACIP recommends giving it at age 60. The new study examined the incidence of herpes zoster (HZ) and postherpetic neuralgia (PHN) and incremental cost per quality-adjusted life-year (QALY) saved. Data were obtained from several U.S.-based vaccine studies. For every 1000 people receiving the vaccine at age 50, 25 HZ cases and 1 PHN case could be prevented. The incremental cost-effectiveness ratio (ICER) for the shingles vaccine vs no vaccine was more than $320,000 per QALY. The ICER can be reduced to less than $100,000 only if the vaccine is priced at ≤ $80 or if there is a decrease in the rate at which the efficacy of the vaccine wanes. The authors concluded that the shingles vaccine does not represent a good value for patients at age 50 years, according to generally accepted standards, and they agreed with the ACIP recommendation not to recommend vaccine for this age group (Ann Intern Med published online Sept. 8, 2015; doi:10.7326/M15-0093).
The shingles vaccine does not represent a good value for patients at age 50 years, according to generally accepted standards.
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