Epidemiology and cost of herpes zoster and post-herpetic neuralgia in the United Kingdom

Abstract

Recent information on epidemiology and management of herpes zoster (HZ) and post-herpetic neuralgia (PHN), a painful complication of HZ, is scarce. The objective of this study was to document the burden of HZ and PHN in the United Kingdom. This retrospective analysis of the UK General Practice Research Database aimed to estimate HZ incidence and proportion of HZ patients developing PHN and to assess management costs in immunocompetent individuals aged 50 years. A cohort of 27 225 HZ patients was selected, corresponding to an incidence of 5.23/1000 person-years. Respectively 19.5% and 13.7% of patients developed PHN at least 1 and 3 months after HZ diagnosis. Mean direct cost was pound103 per HZ patient and pound341 and pound397 per PHN episode (1- and 3-month definition respectively). Both HZ and PHN costs increased markedly with pain severity. This study confirms that HZ and PHN are frequent and costly diseases in the United Kingdom.

Cost-effectiveness of vaccination against herpes zoster

“…For instance, in the US, healthcare costs per acute episode of HZ were estimated at $431 and in the UK, healthcare costs of HZ and PHN were ≤103 and ≤397 per episode, respectively. 28,29 After the results of the SPS were published, multiple costeffectiveness analyses for different countries have been performed. The aim of this review is to summarize and synthesize the literature on cost-effectiveness of routine vaccination against HZ and to identify those input parameters that are crucial in determining cost-effectiveness outcomes.…”

The Epidemiology and Prevention of Herpes Zoster

“…The most common complication of zoster is post-herpetic neuralgia (PHN), which develops in around 20% of individuals aged ≥50 years [3]. PHN is often defined as pain persisting for >90 days after the onset of the rash; the pain can be very severe and remain for years [4].…”

Immunogenicity and safety of a live attenuated shingles (herpes zoster) vaccine (Zostavax®) in individuals aged ≥ 70 years: A randomized study of a single dose vs. two different two-dose schedules

“…14 The severity and the risk of both HZ and PHN increase with age. 4,15,16 Thus, more than two-thirds of HZ cases occur in individuals aged > 50 y, 17 and 20-50% of adults with HZ aged ≥ 50 y develop PHN. 18,19 As the population ages, the number of cases of HZ and PHN is expected to rise.…”