Evidence map›Paper›PMID 41085856›Full record

ArticleThe European journal of health economics : HEPAC : health economics in prevention and care2026

Informing decisions in light of parameter uncertainty - an economic evaluation of the adjuvanted recombinant herpes zoster vaccine in Sweden.

Camilla Nystrand, Katarina Widgren, Shuang Hao, Emelie Heintz, Vibeke Sparring

Abstract read
In one paragraph

Article in The European journal of health economics : HEPAC : health economics in prevention and care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Camilla NystrandDepartment of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden. Camilla.nystrand-lansman@regionstockholm.se.ORCID http://orcid.org/0000-0002-9866-1100
Katarina WidgrenDepartment of Communicable Disease Control and Prevention, Stockholm, Region Stockholm, Sweden.ORCID http://orcid.org/0000-0002-5713-0071
Shuang HaoCenter for Health Economics, Informatics and Healthcare Research, Health Care Services Stockholm County (SLSO), Stockholm, Region Stockholm, Sweden.ORCID http://orcid.org/0000-0002-2303-4532
Emelie HeintzDepartment of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden.ORCID http://orcid.org/0000-0002-0715-7591
Vibeke SparringDepartment of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden.ORCID http://orcid.org/0000-0002-1248-8600

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMany studies of the adjuvanted recombinant zoster vaccine (RZV) consider it cost-effective using efficacy estimates from randomized trials (RCTs). However, the effect magnitude differs between RCTs and observational studies, in addition to other input parameters that have shown to greatly impact cost-effectiveness. The aim of the current study is to assess the economic case of the RZV in Sweden and assess at which price the vaccine would be considered cost-effective.

methodsA decision-analytic model was used to estimate the health economic impact of introducing RZV in Sweden. Five-year age-cohorts were modelled between ages 65 to 100+, comparing the cost-effectiveness of two-dose RZV to no vaccination from a health care perspective, using efficacy data from RCTs and observational estimates. The model was run over a lifetime time horizon with quality adjusted life years (QALYs) as the outcome. Multiple one-way and probabilistic sensitivity analyses were conducted to analyze the impact of parameter uncertainty.

resultsAt a willingness-to-pay of 80,000 Euro per QALY, the RZV was cost-effective across cohorts at a price per dose of 80 to 105 Euro in basecase analyses, in contrast to the current market price at 176 Euro. However, due to parameter uncertainty, the price per dose at which the RZV may be considered cost-effective varies between as high as the current market price to less than 10% of that price, depending on which input variables are used.

conclusionThe price at which the RZV would be considered cost-effective varies greatly, highlighting the need to explore and consider parameter uncertainty in both analyses and procurement negotiations.

Indexed as

Herpes ZosterHerpes Zoster VaccineAgedAged, 80 and overCost-Benefit AnalysisDecision Support TechniquesFemaleHumansMaleQuality-Adjusted Life YearsSwedenUncertaintyHerpes Zoster VaccineAdjuvanted recombinant zoster vaccineCost-effectivenessHealth economicsHerpes zosterRZVShingles

Identifiers

PMID41085856
PMCPMC13190775

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.