Economic Burden of Herpes Zoster by Age Group in Immunocompetent Patients in the United States
Methods: This was a retrospective case-control analysis using the Truven Health MarketScan® Research databases (2008-2011) to determine the incremental direct and indirect cost associated with HZ. Cases were identified by a diagnosis code for HZ (ICD-9-CM: 053.xx), continuous enrollment 12 months pre/post diagnosis, and lacking a prior diagnosis for or vaccination against HZ. Cases were matched to immunocompetent controls without HZ using demographic and clinical variables and baseline medical expenditures. Healthcare costs, resource utilization, and indirect costs were descriptively compared between those with and without HZ from 21 days prior through one year following diagnosis.
Results: A total of 98,916 cases were identified and matched 1:1 to controls. We found a significant difference in average total healthcare cost between patients with HZ and patients without HZ ($6,241 vs $4,933, p<0.001), leading to an average incremental healthcare cost of $1,308. Total cost to treat HZ and related utilization increased with age, peaking at over $13,000 for those 80 years and older. Incremental costs to treat HZ in patients aged 50-59 was higher than in patients aged 60-69, ($1,614 vs $1,249, p<0.001). Significant incremental indirect costs due to work absence (ABS) and short-term disability (STD) were also observed in HZ patients aged 50-59 (ABS=$885, STD=$206) and those aged 60-64 years (ABS=$715, STD=$304).
Conclusion: HZ burden in adults can lead to considerable incremental healthcare and work loss-related costs. Significant resources are currently being expended on patients aged 50-59, for which the vaccine is approved, but not yet ACIP recommended.
Truven Health Analytics: Employee, Salary
L. Palmer, Truven Health Analytics: Employee, Salary
G. Lenhart, Truven Health Analytics: Employee, Salary
K. Kawai, Merck & Co., Inc.: Employee, Salary
C. Acosta, Merck & Co., Inc.: Employee and Shareholder, Salary