(717): Healthcare expenditures in patients with herpes zoster pain and postherpetic neuralgia

Abstract

Because existing data on medical costs associated with acute and persisting pain associated with herpes zoster are limited, healthcare expenditures were estimated in patients covered by commercial, Medicare, and Medicaid insurance. The MEDSTAT Group’s Marketscan Databases, composed of medical, pharmacy, and enrollment information, were used. Patients were included if they had evidence of a claim with a primary diagnosis of herpes zoster accompanied by a pain medication prescription or with a primary diagnosis of postherpetic neuralgia (PHN). The index date was first evidence of such a claim from 7/1/2001-12/31/2003. Patient demographics and healthcare expenditures were measured in the 6 months prior to the index date and the following 12 months for the commercial and Medicare cohorts; for the Medicaid cohort, follow-up was only 6 months because data were limited. A propensity score model was used to match controls to each insured cohort, controlling for differences in patient demographics (age, gender, location, insurance type, index year) and health status (Charlson Comorbidity Index, psychiatric diagnostic groups). A total of 1,032 commercial, 811 Medicare, and 604 Medicaid patients with herpes zoster pain or PHN were studied. Prior to matching, the cohorts and controls were significantly different in terms of demographics and health status. After matching, patient demographics were similar, but the health status of the cohorts was still significantly different, with the pain cohorts having greater comorbidities. The difference in average annual healthcare expenditures between the pain cohorts and their matched controls were $4,916 (p<0.01) in a commercial population, $2,695 (p<0.01) in a Medicare population, and $9,312 (p<0.01) in a Medicaid population. The additional healthcare expenditures associated with herpes zoster pain and PHN are considerable, averaging between $2,695 and $9,312 per year per patient depending on the population. Sponsored by grants from Endo Pharmaceuticals to The MEDSTAT Group and the University of Rochester. Because existing data on medical costs associated with acute and persisting pain associated with herpes zoster are limited, healthcare expenditures were estimated in patients covered by commercial, Medicare, and Medicaid insurance. The MEDSTAT Group’s Marketscan Databases, composed of medical, pharmacy, and enrollment information, were used. Patients were included if they had evidence of a claim with a primary diagnosis of herpes zoster accompanied by a pain medication prescription or with a primary diagnosis of postherpetic neuralgia (PHN). The index date was first evidence of such a claim from 7/1/2001-12/31/2003. Patient demographics and healthcare expenditures were measured in the 6 months prior to the index date and the following 12 months for the commercial and Medicare cohorts; for the Medicaid cohort, follow-up was only 6 months because data were limited. A propensity score model was used to match controls to each insured cohort, controlling for differences in patient demographics (age, gender, location, insurance type, index year) and health status (Charlson Comorbidity Index, psychiatric diagnostic groups). A total of 1,032 commercial, 811 Medicare, and 604 Medicaid patients with herpes zoster pain or PHN were studied. Prior to matching, the cohorts and controls were significantly different in terms of demographics and health status. After matching, patient demographics were similar, but the health status of the cohorts was still significantly different, with the pain cohorts having greater comorbidities. The difference in average annual healthcare expenditures between the pain cohorts and their matched controls were $4,916 (p<0.01) in a commercial population, $2,695 (p<0.01) in a Medicare population, and $9,312 (p<0.01) in a Medicaid population. The additional healthcare expenditures associated with herpes zoster pain and PHN are considerable, averaging between $2,695 and $9,312 per year per patient depending on the population. Sponsored by grants from Endo Pharmaceuticals to The MEDSTAT Group and the University of Rochester.