Aggregate health and economic burden of herpes zoster in the United States: illustrative example of a pain condition. Issue 2 (February 2020)

• Record Type: Journal Article
• Authors: Harvey, Michael; Prosser, Lisa A.; Rose, Angela M.; Ortega-Sanchez, Ismael R.; Harpaz, Rafael
• Is Part Of: Pain. Volume 161:Issue 2(2020)
• Publication Date: 2020-02
• Subjects: Herpes zoster -- Postherpetic neuralgia -- Economic burden; Pain -- Periodicals; Douleur -- Périodiques; Anesthésie -- Périodiques; Pain; Electronic journals; Periodicals; Electronic journals; 616.0472
• DOI: 10.1097/j.pain.0000000000001718
• Languages: English
• ISSNs: 0304-3959

Abstract

Abstract : Abstract: Our objective was to develop comprehensive national estimates of the total burden of herpes zoster (HZ) among U.S. adults, including direct (ie, medical costs) and indirect (ie, productivity losses) costs, as well as its psychosocial impact (ie, quality of life losses). Using a patient-level microsimulation model, we projected health and economic outcomes among U.S. adults aged 18 years and older using a 10-year time horizon. We conducted a comprehensive systematic literature review to generate parameter values and conducted simulation modeling to generate our outcomes, including numbers of cases of uncomplicated HZ, postherpetic neuralgia (PHN), and ocular complications, productivity losses, and losses in quality-adjusted life years (QALYs). We used a societal perspective for outcomes; the costing year was 2015. Projected outcomes for an unvaccinated population included 1.1 million HZ cases, 114, 000 PHN cases, and 43, 000 ocular complications annually, resulting in approximately 67, 000 QALYs lost. HZ and its complications would incur costs of $2.4 billion in direct medical costs and productivity losses annually. Projected QALY losses were most sensitive to HZ and PHN health utility values in the model. Cost estimates were most sensitive to the probability of HZ and to the costs per episode of PHN. The national burden of direct, indirect, and psychosocial HZ costs is substantial. Our results can inform economic analyses for HZ vaccines. Comprehensive, national assessments of the total burden of other painful conditions would be very informative. Abstract : Supplemental Digital Content is Available in the Text.Using simulation modeling, an unvaccinated U.S. population would be projected to experience 1.1 million herpes zoster cases annually, with an associated direct medical cost of $2.4 billion.