Abstract
BackgroundTo estimate the health care resource utilization, costs, and impact on quality of life (QoL) of herpes zoster (HZ) and postherpetic neuralgia (PHN) in adults aged ≥50 years in Italy.MethodsThis was a prospective, observational, multicenter, community physician–based surveillance study (NCT01772160) in Italy. Health-related QoL data were collected using the EuroQoL-5 Dimension (EQ-5D) and Zoster Brief Pain Inventory (ZBPI) questionnaires. Both questionnaires were assessed at days 0 (HZ rash onset), 15, 30, 60, and 90 for all patients, and monthly thereafter for patients who developed PHN. Resource utilization was recorded for 3 months post–HZ onset and 9 months for PHN patients. Costs from both payer and societal perspectives were estimated and were composed of direct medical costs (general practitioner/specialist visits, procedures, hospitalizations, medications), work loss by patient/caregiver, and transport costs.ResultsA total of 391 patients with HZ were included, of whom 40 developed PHN. The mean ZBPI worst pain score was 5.7 at day 0, reducing to 2.6 at day 30 and 0.7 by day 90. Patients with PHN had a mean worst pain score of 5.7 at day 90. We estimated an overall disutility associated with HZ of 0.134. The mean cost per HZ patient from a payer/societal perspective was €153/€298, respectively, and the mean cost per HZ patients who developed PHN was €176/€426, respectively.ConclusionsHZ is associated with impaired QoL and substantial health care resource use, highlighting the need for preventive strategies. This could reduce the disease burden for the patient and health care system.ClinicalTrials.gov study registryNCT01772160.
Highlights
herpes zoster (HZ) is associated with impaired quality of life (QoL) and substantial health care resource use, highlighting the need for preventive strategies
Herpes zoster (HZ), or “shingles,” is a viral disease characterized by a painful skin rash that results from the reactivation of latent varicella zoster virus from the dorsal root or cranial nerve ganglia
Our study showed that HZ had a large economic burden and a substantial impact on the patients’ QoL and ability to function in their normal activities
Summary
This was a prospective, observational, multicenter, community physician–based surveillance study (NCT01772160) in Italy. Health-related QoL data were collected using the EuroQoL-5 Dimension (EQ-5D) and Zoster Brief Pain Inventory (ZBPI) questionnaires Both questionnaires were assessed at days 0 (HZ rash onset), 15, 30, 60, and 90 for all patients, and monthly thereafter for patients who developed PHN. Resource utilization was recorded for 3 months post–HZ onset and 9 months for PHN patients Costs from both payer and societal perspectives were estimated and were composed of direct medical costs (general practitioner/ specialist visits, procedures, hospitalizations, medications), work loss by patient/caregiver, and transport costs. This prospective, observational, multicenter community-based study was carried out in primary care practices in northern Italy from 2013 to 2016 (ClinicalTrials.gov Identifier: NCT01772160). Patients who were still experiencing pain at day 180 were invited to continue in the study until day 270
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