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Observational Study
. 2021 Jun;38(6):3325-3341.
doi: 10.1007/s12325-021-01717-7. Epub 2021 May 19.

Economic Burden and Impact on Quality of Life of Herpes Zoster in Spanish Adults Aged 50 Years or Older: A Prospective Cohort Study

Javier Díez-Domingo  1 , Desmond Curran  2 , Maria Del Rosario Cambronero  3 , Juan-Antonio Garcia-Martinez  4 , Sean Matthews  2
Affiliations
Observational Study

Economic Burden and Impact on Quality of Life of Herpes Zoster in Spanish Adults Aged 50 Years or Older: A Prospective Cohort Study

Javier Díez-Domingo et al. Adv Ther. 2021 Jun.

Abstract

Introduction: The economic burden of herpes zoster (HZ), including its most common complication, postherpetic neuralgia (PHN), and its impact on health-related quality of life (HRQL) is not well described in Spain. The aim of this study was to estimate HZ-related healthcare costs and impact on HRQL in Spanish adults aged 50 years or older.

Methods: A prospective, observational study was performed with patients with HZ recruited through four general practitioner networks in Spain (NCT01521286). HRQL data were collected using the EuroQoL-5 Dimension (EQ-5D) questionnaire; HZ-related pain and associated interference with activities of daily living (ADL) were assessed using the Zoster Brief Pain Inventory (ZBPI) questionnaire at days 0 (HZ rash onset), 15, 30, 60, and 90; patients with PHN were assessed up until day 270. Medical resource utilization was recorded throughout study follow-up. Work loss for patients/caregivers was also assessed. Costs were calculated from both the payer and societal perspectives.

Results: A total of 545 patients with Hz were included, of whom 25 developed PHN. During days 0-30 post HZ diagnosis, the mean EQ-5D utility score was 0.738, equating to a utility loss of 0.138. Sleep was the ADL most affected component. The mean costs for HZ in the overall cohort were €240 and €296 from the payer/societal perspective, respectively; €187/€242 for patients with HZ without any HZ-related complications; and €571/€712 for patients who developed PHN. The majority of costs were incurred during days 0-30.

Conclusions: In Spain, HZ and HZ-related complications such as PHN reduce patient HRQL and increase the economic burden for both payers and society in general.

Trail registration: ClinicalTrials.gov identifier NCT01521286.

Keywords: Economic burden; Herpes zoster; Impact; Postherpetic neuralgia; QALY; Quality of life.

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Figures

Fig. 1
Fig. 1
ZBPI worst pain score over time until day 90 by PHN status and by age. n number of subjects, PHN postherpetic neuralgia, YOA years of age, ZBPI Zoster Brief Pain Inventory
Fig. 2
Fig. 2
Mean Zoster Brief Pain Inventory (ZBPI) interference with activities of daily living (ADL) over the first 90 days after rash onset
Fig. 3
Fig. 3
Mean EQ-5D utility scores over time by PHN status. EQ-5D EuroQoL-5 Dimension questionnaire, n number of subjects, PHN postherpetic neuralgia
Fig. 4
Fig. 4
Mean costs by payer perspective and complication category (a) and distribution of direct medical costs per herpes zoster episode from the HCS perspective (b) and medical costs and indirect costs from the societal perspective (c). HCS healthcare system, HZ herpes zoster, GP general practitioner, n number of patients, PHN postherpetic neuralgia
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References

    1. Cohen JI. Clinical practice: herpes zoster. N Engl J Med. 2013;369:255–263. doi: 10.1056/NEJMcp1302674. - DOI - PMC - PubMed
    1. Kawai K, Rampakakis E, Tsai TF, et al. Predictors of postherpetic neuralgia in patients with herpes zoster: a pooled analysis of prospective cohort studies from North and Latin America and Asia. Int J Infect Dis. 2015;34:126–131. doi: 10.1016/j.ijid.2015.03.022. - DOI - PubMed
    1. Katz J, Cooper EM, Walther RR, Sweeney EW, Dworkin RH. Acute pain in herpes zoster and its impact on health-related quality of life. Clin Infect Dis. 2004;39:342–348. doi: 10.1086/421942. - DOI - PubMed
    1. Coplan PM, Schmader K, Nikas A, et al. Development of a measure of the burden of pain due to herpes zoster and postherpetic neuralgia for prevention trials: adaptation of the brief pain inventory. J Pain. 2004;5:344–356. doi: 10.1016/j.jpain.2004.06.001. - DOI - PubMed
    1. Oster G, Harding G, Dukes E, Edelsberg J, Cleary PD. Pain, medication use, and health-related quality of life in older persons with postherpetic neuralgia: results from a population-based survey. J Pain. 2005;6:356–363. doi: 10.1016/j.jpain.2005.01.359. - DOI - PubMed

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