Matthews Sean, De Maria Antonio, Passamonti Marco, Ristori Giovanni, Loiacono Idalba, Puggina Anna, Curran Desmond
Value Evidence, GSK, Wavre, Belgium.
Investigator site, Puglia, Galatina, Italy.
Open Forum Infect Dis. 2019 Jan 12;6(2):ofz007. doi: 10.1093/ofid/ofz007. eCollection 2019 Feb.
To estimate the health care resource utilization, costs, and impact on quality of life (QoL) of herpes zoster (HZ) and postherpetic neuralgia (PHN) in adults aged ≥50 years in Italy.
This was a prospective, observational, multicenter, community physician-based surveillance study (NCT01772160) in Italy. Health-related QoL data were collected using the EuroQoL-5 Dimension (EQ-5D) and Zoster Brief Pain Inventory (ZBPI) questionnaires. Both questionnaires were assessed at days 0 (HZ rash onset), 15, 30, 60, and 90 for all patients, and monthly thereafter for patients who developed PHN. Resource utilization was recorded for 3 months post-HZ onset and 9 months for PHN patients. Costs from both payer and societal perspectives were estimated and were composed of direct medical costs (general practitioner/specialist visits, procedures, hospitalizations, medications), work loss by patient/caregiver, and transport costs.
A total of 391 patients with HZ were included, of whom 40 developed PHN. The mean ZBPI worst pain score was 5.7 at day 0, reducing to 2.6 at day 30 and 0.7 by day 90. Patients with PHN had a mean worst pain score of 5.7 at day 90. We estimated an overall disutility associated with HZ of 0.134. The mean cost per HZ patient from a payer/societal perspective was €153/€298, respectively, and the mean cost per HZ patients who developed PHN was €176/€426, respectively.
HZ is associated with impaired QoL and substantial health care resource use, highlighting the need for preventive strategies. This could reduce the disease burden for the patient and health care system.
NCT01772160.
评估意大利≥50岁成年人带状疱疹（HZ）和带状疱疹后神经痛（PHN）的医疗资源利用情况、成本及其对生活质量（QoL）的影响。
这是一项在意大利开展的前瞻性、观察性、多中心、基于社区医生的监测研究（NCT01772160）。使用欧洲五维健康量表（EQ - 5D）和带状疱疹简明疼痛量表（ZBPI）问卷收集与健康相关的生活质量数据。所有患者在第0天（HZ皮疹发作）、15天、30天、60天和90天评估这两份问卷，此后对于发生PHN的患者每月评估一次。记录HZ发作后3个月的资源利用情况以及PHN患者9个月的资源利用情况。从支付方和社会角度估算成本，成本包括直接医疗成本（全科医生/专科医生诊疗、手术、住院、药物）、患者/护理人员的工作损失以及交通成本。
共纳入391例HZ患者，其中40例发生PHN。第0天ZBPI最严重疼痛评分的平均值为5.7，第30天降至2.6，第90天降至0.7。PHN患者在第90天最严重疼痛评分的平均值为5.7。我们估计与HZ相关的总体失能调整生命年为0.134。从支付方/社会角度来看，每位HZ患者的平均成本分别为153欧元/298欧元，发生PHN的HZ患者平均成本分别为176欧元/426欧元。
HZ与生活质量受损及大量医疗资源使用相关，凸显了预防策略的必要性。这可以减轻患者和医疗系统的疾病负担。
NCT01772160。
