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

Figures & data

Table 1. Demographics and baseline clinical characteristics of all study cohorts.

	HZ without PHN		HZ with PHN		All HZ Cases		Matched Controls		Standardizeddifference*
	n	%	n	%	n	%	n	%
n	96,511		2,405		98,916		98,916
Age†	50.2	18.8	61.7	16.7	50.4	18.8	50.2	19.2	1.2%
Age group
<50	41,394	42.9	541	22.5	41,935	42.4	41,935	42.4	0%
50–59	24,421	25.3	536	22.3	24,957	25.2	24,957	25.2	0%
60–64	12,632	13.1	330	13.7	12,962	13.1	12,962	13.1	0%
65–69	4770	4.9	198	8.2	4968	5.0	4968	5.0	0%
70–79	7855	8.1	391	16.3	8246	8.3	8246	8.3	0%
80+	5439	5.6	409	17.0	5848	5.9	5848	5.9	0%
Gender
Male	42 117	43.6	861	35.8	42,978	43.4	42,978	43.4	0%
Female	54,394	56.4	1544	64.2	55,938	56.6	55,938	56.5	0%
Health plan type
Comprehensive	9900	10.3	451	18.7	10,351	10.5	10,351	10.5	0%
HMO	52,794	54.7	1148	47.7	53,942	54.5	53,942	54.5	0%
POS	7,769	8.0	152	6.3	7921	8.0	7921	8.0	0%
PPO/EPO	17,873	18.5	501	20.8	18,374	18.6	18,374	18.6	0%
CDHP/HDHP	4301	4.5	61	2.5	4362	4.4	4362	4.4	0%
Other/Unknown	3874	4.0	92	3.8	3966	4.0	3966	4.0	0%
Primary Insurance
Commercial	78 783	81.6	1425	59.2	80,208	81.1	80,208	81.1	0%
Medicare	17,728	18.4	980	40.7	18,708	18.9	18,708	18.9	0%
Geographic region
Northeast	14,751	15.3	344	14.3	15,095	15.3	15,095	15.3	0%
North Central	28,167	29.2	693	28.8	28,860	29.2	28,860	29.2	0%
South	30,857	32.0	669	27.8	31,526	31.9	31,526	31.9	0%
West	21,957	22.7	680	28.3	22,637	22.9	22,637	22.9	0%
Unknown	779	0.8	19	0.8	798	0.8	798	0.8	0%
Employee relationship
Employee	60,181	62.4	1,706	70.9	61,887	62.6	61,420	62.1	1.0%
Spouse	25,613	26.5	655	27.2	26,268	26.6	26,493	26.8	0.5%
Child/Other	10,717	11.1	44	1.8	10,761	10.9	11,003	11.1	0.8%
Charlson Comorbidity Index†	0.29	0.72	0.52	0.97	0.29	0.73	0.29	0.73	0.2%
Pre-period Expenditures†	4810	11,918	7639	16,506	4879	12,058	4357	12,762	4.0%

* Comparison is between All HZ cases and matched controls.

† Presented as mean (± SD).

HMO, health maintenance organization; POS, point-of-service; PPO/EPO, preferred provider organization/exclusive provider organization; CDHP/HDHP, consumer-driven health plan/high-deductible health plan.

Table 2. Annual incremental healthcare utilization associated with herpes zoster stratified by PHN status and age category.

	Inpatient admissions		ER visits		Outpatient office visits		Other outpatient services
	Mean (no. of visits)	95% CI	Mean (no. of visits)	95% CI	Mean (no. of visits)	95% CI	Mean (no. of visits)	95% CI
All patients	0.016	0.013–0.018	0.153	0.146–0.159	2.116	2.077–2.155	3.730	3.525–3.935
PHN status
HZ w/out PHN	0.014	0.011–0.017	0.146	0.140–0.153	2.026	1.987–2.065	3.504	3.298–3.709
HZ with PHN	0.091	0.065–0.116	0.410	0.354–0.465	5.729	5.398–6.060	12.818	11.232–14.403
Age group
<50 years	0.006	0.003–0.008	0.139	0.130–0.149	1.887	1.840–1.934	2.968	2.691–3.244
50–59 years	0.011	0.006–0.016	0.140	0.128–0.151	2.145	2.073–2.217	4.295	3.876–4.714
60–64 years	0.017	0.009–0.025	0.146	0.130–0.162	2.094	1.985–2.204	4.499	3.898–5.100
65–69 years	0.021	0.007–0.034	0.157	0.132–0.182	2.359	2.162–2.557	3.895	3.012–4.777
70–79 years	0.026	0.013–0.039	0.180	0.154–0.206	2.586	2.415–2.758	3.706	2.947–4.464
>80 years	0.080	0.059–0.101	0.277	0.233–0.321	2.815	2.588–3.041	4.977	3.925–6.028

All p-values <0.01.

Figure 1. Annual incremental cost associated with herpes zoster by healthcare resource utilization category.

Figure 2. Annual incremental office visits associated with herpes zoster by PHN status and age group.

Table 3. Annual incremental healthcare cost associated with herpes zoster stratified by PHN status and age category.

	HZ			Non-HZ (matched)
	n	Mean (US$)	SD	n	Mean (US$)	SD	Incremental costassociated with HZ (US$)	95% CI
All patients	98,916	6241	14,373	98,916	4933	13,912	1308	1184–1433
PHN status
HZ w/out PHN	96,511	6094	14,199	96,511	4890	13,901	1205	1079–1330
HZ with PHN	2405	12,133	19,259	2405	6671	14,230	5463	4505–6420
Age group
<50 years	41,935	3952	10,510	41,935	3012	9742	940	803–1077
50–59 years	24,957	6359	14,985	24,957	4745	11,408	1614	1380–1847
60–64 years	12,962	7543	15,592	12,962	6290	21,723	1253	792–1713
65–69 years	4968	7680	14,801	4968	6441	14,790	1239	657–1821
70–79 years	8246	9748	18,208	8246	8033	15,930	1715	1193–2237
>80 years	5848	13,099	21,081	5848	10,842	19,164	2256	1526–2987

All p-values <0.001.

Figure 3. Annual incremental cost associated with herpes zoster by age and healthcare resource utilization category.