Healthcare resource utilization and costs associated with herpes zoster in the US

Abstract

Objectives: To evaluate the economic burden of herpes zoster (HZ) on the US healthcare system among an immunocompetent population.

Methods: Claims data from the MarketScan Research databases for 2008–2011 were extracted to determine the incremental healthcare resource utilization (RU) and direct medical costs associated with HZ. Immunocompetent HZ-patients were identified and directly matched 1:1 with immunocompetent non-HZ controls using demographic and clinical variables. Analysis was limited to claims 21 days prior to through the first year following HZ diagnosis. Cases with post-herpetic neuralgia (PHN) were analyzed separately.

Results: A total of 98,916 HZ-patients were matched to controls. HZ-patients had a mean age of 50.4 (SD = 18.8) years and 56.6% were females. HZ-cases had significantly higher RU (0.016 inpatient visits, 0.153 ER visits, 2.116 outpatient office visits, and 3.730 other outpatient services) compared to controls (p < 0.001). Differences increased substantially in the presence of PHN. Total mean incremental healthcare costs for HZ-cases were $1308 and quadrupled to $5463 in those with PHN (both p < 0.001). Overall, primary cost drivers were outpatient prescriptions and other outpatient services. For those with PHN, inpatient services also played a significant role.

Limitations: This study was limited to only those individuals with US commercial health coverage or private Medicare supplemental coverage; therefore, results of this analysis may not be generalizable to HZ patients outside of the US, with other health insurance or without coverage.

Conclusions: HZ presents a significant economic and resource burden on the US healthcare system among immunocompetent patients of nearly all ages, particularly when complicated by PHN.

Keywords:

• Herpes zoster
• PHN
• healthcare resource utilization and costs
• case control
• administrative claims data
• immunocompetent population

Transparency

Declaration of funding

This manuscript and the work described herein was funded by Merck & Co., Inc.

Declaration of financial/other relationships

Truven Health Analytics provides study design, programming, analysis, and manuscript development for major pharmaceutical and biotech firms. BHJ, LP, and GL are employees of Truven Health Analytics. JG was an employee of Truven Health Analytics at the time of the study and manuscript preparation. KK was a consultant working for Merck & Co., Inc. at the time of the study and manuscript preparation; and CJA is an employee of Merck & Co. Inc. JME peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgment

The authors wish to acknowledge Santosh Tiwari for his editorial contribution to this study.

Notes

†ZOSTAVAX is a registered trademark of Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Whitehouse Station, NJ.

‡MarketScan is a registered trademark of Truven Health Analytics.