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

Barbara H. Johnson, Liisa Palmer, Justin Gatwood, Gregory Lenhart, Kosuke Kawai, Camilo J. Acosta

Research output: Contribution to journalArticle

6 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)928-935
Number of pages8
JournalJournal of Medical Economics
Volume19
Issue number10
DOIs
StatePublished - Oct 2 2016

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Herpes Zoster
Delivery of Health Care
Costs and Cost Analysis
Neuralgia
Ambulatory Care
Inpatients
Outpatients
Economics
Office Visits
Health Insurance
Medicare
Health Care Costs
Prescriptions
Demography
Databases

All Science Journal Classification (ASJC) codes

  • Health Policy

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Healthcare resource utilization and costs associated with herpes zoster in the US. / Johnson, Barbara H.; Palmer, Liisa; Gatwood, Justin; Lenhart, Gregory; Kawai, Kosuke; Acosta, Camilo J.

In: Journal of Medical Economics, Vol. 19, No. 10, 02.10.2016, p. 928-935.

Research output: Contribution to journalArticle

Johnson, Barbara H. ; Palmer, Liisa ; Gatwood, Justin ; Lenhart, Gregory ; Kawai, Kosuke ; Acosta, Camilo J. / Healthcare resource utilization and costs associated with herpes zoster in the US. In: Journal of Medical Economics. 2016 ; Vol. 19, No. 10. pp. 928-935.
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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.",
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