Epidemiology and economic burden of herpes zoster and post-herpetic neuralgia in Italy: A retrospective, population-based study

Gialloreti, Leonardo Emberti; Merito, Monica; Pezzotti, Patrizio; Naldi, Luigi; Gatti, Antonio; Beillat, Maud; Serradell, Laurence; Marzo, Rafaelle di; Volpi, Antonio

doi:10.1186/1471-2334-10-230

Cited by 147 publications

(183 citation statements)

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“…In this issue, Stefania Maggi and collaborators present a comprehensive and upto-date review of how the HZ vaccine improves healthy ageing [8]. This paper raises some questions concerning the global epidemiology of the disease, improved knowledge of HZ risk factors, the well-known and more surprising consequences of the disease, as well as the increasing dilemma about age and the new indications for the currently available vaccine.The incidence rate (IR) of HZ in Italy, at 6.3 per thousand person-years [8,9], is higher than the mean incidence rate of 3-5 per thousand person-years reported in an analysis of 130 studies conducted in 26 countries in North America, Europe, and Asia-Pacific [10]. This could be related to a temporal increase in the incidence of HZ, often occurring before the introduction of varicella vaccination programmes [11], as in Finland [11] and Germany [12].…”

mentioning

confidence: 99%

“…The incidence rate (IR) of HZ in Italy, at 6.3 per thousand person-years [8,9], is higher than the mean incidence rate of 3-5 per thousand person-years reported in an analysis of 130 studies conducted in 26 countries in North America, Europe, and Asia-Pacific [10]. This could be related to a temporal increase in the incidence of HZ, often occurring before the introduction of varicella vaccination programmes [11], as in Finland [11] and Germany [12].…”

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confidence: 99%

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Herpes zoster vaccine: a shot to maintain wellbeing

Michel¹

2015

Aging Clin Exp Res

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The current era is full of contradictory vaccine issues. The emerging Ebola pandemic stimulates the world's citizens who are calling for the urgent development of vaccine to prevent the disease [1]. They seem to be suddenly remembering that vaccines represent a major advancement in public health [2]. While the complete eradication of polio, neonatal tetanus, congenital rubella, and measles are still the main targets in less developed countries [3], inhabitants of high-resource countries are focusing on rare adverse effects of vaccines to discredit the efficacy and effectiveness of vaccination. As a result, there is an increase in vaccine-preventable diseases in both children and adults. Indeed, it has been estimated that ten times more adults (40 to 50 thousand) die than children in the USA annually from potentially vaccine-preventable diseases [4].In this controversial context, alongside vaccines for lifethreatening diseases, there have emerged new vaccines to prevent the occurrence of diseases and their complications. Herpes zoster (HZ) vaccine [5][6][7], is the best example of such quality improvement vaccines. In this issue, Stefania Maggi and collaborators present a comprehensive and upto-date review of how the HZ vaccine improves healthy ageing [8]. This paper raises some questions concerning the global epidemiology of the disease, improved knowledge of HZ risk factors, the well-known and more surprising consequences of the disease, as well as the increasing dilemma about age and the new indications for the currently available vaccine.The incidence rate (IR) of HZ in Italy, at 6.3 per thousand person-years [8,9], is higher than the mean incidence rate of 3-5 per thousand person-years reported in an analysis of 130 studies conducted in 26 countries in North America, Europe, and Asia-Pacific [10]. This could be related to a temporal increase in the incidence of HZ, often occurring before the introduction of varicella vaccination programmes [11], as in Finland [11] and Germany [12]. In the United Kingdom, one study reported that the median age at HZ diagnosis was 62 years (interquartile range 48-73) [13]. The IR was more or less stable between the ages of 10 and 44 years (at around 2.4 per thousand personyears), but increased more than threefold, to reach 15 in the 80-84 year old age group [12]. In the same study population, the IR was 36 % higher in females than in males [12]. Prodromic pain was experienced by 69.5 % of South Korean patients, of whom 95.1 % had moderate-to-severe pain [14]. In Italy, postherpetic neuralgia (PHN) occurred in 20.6 and 9.2 % of HZ patients older than 50 years after 3 and 6 months respectively [8,15], which corresponds to the mean 6-month PHN risk reported in the world literature [16].The risk factors for HZ have recently been better identified, and Maggi's paper describes them in detail [8]. However, it is important to insist on a few of these factors. In a study cohort of 144,959 adults diagnosed with herpes zoster between 2000 and 2011, severely immunosuppressive conditions r...

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Herpes zoster vaccine: a shot to maintain wellbeing

Michel¹

2015

Aging Clin Exp Res

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“…In Italy, the estimated number of new HZ cases occurring each year in the population aged over 50 is about 160,000, and the annual incidence rate is 6.3/1,000 personyears [22].…”

Section: Clinical Aspects and Epidemiologymentioning

confidence: 99%

Preventing and managing herpes zoster: key actions to foster healthy aging

et al. 2015

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Population aging is the demographic phenomenon characterizing all countries in the world, and it is challenging the national infrastructures, in particular health systems. However, aging itself is not associated with increased medical spending, but disability and comorbidity that affect older individuals are the actual drivers for health expenditures. Therefore, if people age in better health, medical spending may be significantly reduced. Preventative interventions proved to be effective in reducing/preventing disease and disability and often found to be cost effective, include diet and exercise interventions, medications, routine disease screenings, and immunizations. Vaccination can protect older citizens against life-threatening diseases, such as influenza, pneumococcal infections, tetanus, and against diseases which adversely impact their quality of life, such as herpes zoster (HZ). Including HZ vaccination in its citizens' lifetime immunization calendar can reinforce Europe's commitment toward active, healthy aging. This paper outlines the consensus statement of a group of Italian experts on HZ.

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“…It has been derived from questionnaires administered to GPs in Liguria, Puglia, Tuscany and Veneto. The average salary has been collected by Gialloreti et al 29 Finally, in the hypothesis that the multi-cohort vaccination strategies are still too onerous for the organizational and financial sustainability of the NHS, a clinical and economic evaluation has been performed to locate, in view of an alternative mono-cohort strategy, which cohort of elderly is preferable to vaccinate (i.e., the cohort of subjects 60, 65 or 70 years aged).…”

Section: Baseline Scenariomentioning

confidence: 99%

Clinical and economic impact of herpes zoster vaccination in elderly in Italy

Boccalini

Alicino

Martinelli

et al. 2016

Human Vaccines & Immunotherapeutics

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Herpes zoster (HZ) is a very relevant pathology among elderly people ( 60 years of age), with a considerable disease burden and loss of quality of life. In the last years a new vaccine against HZ became available in Italy. Therefore, the Italian decision makers are now confronted with the decision whether that vaccination should be implemented. Pharmaco-economic analyses represent useful tools to value the feasibility of new immunization programs and their sustainability. To this aim, an ad hoc population model was developed in order to value the clinical and economic impact of HZ vaccination program for the elderly in Italy. Particularly, different immunization scenarios were modeled: vaccination of 60 years-old subjects (single cohort strategy), simultaneous vaccination of people aged 60 and 65 years (double cohort strategy) and, lastly, immunization of people aged 60, 65 and 70 years (triple cohort strategy), thus leading to the vaccination of 5, 10 and 15 cohorts during the first 5 years of the program. The mathematical model valued the clinical impact of vaccination on the number of HZ, postherpetic neuralgia (PHN) and ophthalmic HZ. The results of the analysis show that, in Italy, a cohortbased HZ vaccination program in elderly could have a relevant impact on the reduction of clinical cases and a favorable economic profile for the National Health Service (NHS), as already foreseen in other countries. In addition, further benefits could be obtained when extending the study period beyond the 5-year horizon of our analysis.

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Epidemiology and economic burden of herpes zoster and post-herpetic neuralgia in Italy: A retrospective, population-based study

Cited by 147 publications

References 40 publications

Herpes zoster vaccine: a shot to maintain wellbeing

Herpes zoster vaccine: a shot to maintain wellbeing

Preventing and managing herpes zoster: key actions to foster healthy aging

Clinical and economic impact of herpes zoster vaccination in elderly in Italy

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