Health care utilization and cost burden of herpes zoster in a community population

Abstract

Objective: To conduct a population-based study to assess health care utilization (HCU) and costs associated with herpes zoster (HZ) and its complications, including postherpetic neuralgia (PHN) and nonpain complications, in adults aged 22 years and older.

Patients and methods: Medical record data on HCU were abstracted for all confirmed new cases of HZ from January 1, 1996, through December 31, 2001, among residents of Olmsted County, Minnesota. Herpes zoster-related costs were estimated by applying the Medicare Payment Fee Schedule to health care encounters and mean wholesale prices to medications. All costs were adjusted to 2006 US dollars using the medical care component of the Consumer Price Index.

Results: The HCU and cost of the 1669 incident HZ cases varied, depending on the complications involved. From 3 weeks before to 1 year after initial diagnosis, there were a mean of 1.8 outpatient visits and 3.1 prescribed medications at a cost of $720 for cases without PHN or nonpain complications compared with 7.5 outpatient visits and 14.7 prescribed medications at a cost of $3998 when complications, PHN, or nonpain complications were present.

Conclusion: The annual medical care cost of treating incident HZ cases in the United States, extrapolated from the results of this study in Olmsted County, is estimated at $1.1 billion. Most of the costs are for the care of immunocompetent adults with HZ, especially among those 50 years and older.

FIGURE 1.

Medication cost by type for all patients with herpes zoster (HZ) (A), HZ patients without postherpetic neuralgia (PHN) or nonpain complications (B), HZ patients with PHN (C), and HZ patients with nonpain complications (D) from 3 weeks before to 1 year after diagnosis.

FIGURE 2.

Mean costs per herpes zoster patient by age and type of health care resource from 3 weeks before to 1 year after diagnosis. ED = emergency department.