Abstract

ABSTRACT The goal of this research was to describe treatment patterns, health-care resource utilization, and costs for herpes zoster (HZ)-related pain, and to estimate the potential impact of recombinant zoster vaccine (RZV) on avoided HZ cases and HZ-related pain prescriptions. This retrospective claims database study included patients from commercial, Medicare, and Medicaid plans between 2012 and 2017. Subjects with an HZ episode were assigned to three cohorts: “opioid”, “non-opioid”, and “no-treatment” cohorts. Subjects in the opioid cohort were matched to a non-HZ cohort. The potential impact of RZV vaccination on HZ case avoidance and resulting painkiller prescriptions was modeled. Over 25% of subjects with an HZ episode received opioids. Adjusted health-care costs were approximately double in the opioid cohort versus non-opioid or matched non-HZ cohorts. Postherpetic neuralgia, immunocompromised status, and comorbidities increased the risk for opioid prescription. RZV vaccination was predicted to avoid over 19,000 patients from receiving opioid prescriptions for every 1 million adults aged ≥50 years. HZ-related prescriptions of opioids were common and led to increased health care costs. RZV vaccination may potentially reduce opioid prescriptions through decreasing HZ incidence.

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