Zarkadoulas Eleftherios, Comparoni Simona, Freguja Riccardo, Santacroce Roberto, Dovizio Melania, Veronesi Chiara, Degli Esposti Luca, Gentile Ivan, Bonanni Paolo, Rossi Alessandro
GSK, Wavre, Belgium.
GSK, Verona, Italy.
Open Forum Infect Dis. 2024 Dec 20;12(1):ofae738. doi: 10.1093/ofid/ofae738. eCollection 2025 Jan.
Risk of herpes zoster (HZ) infection increases with age and immunosuppression. We estimated the impact of HZ and post-herpetic neuralgia (PHN) on direct costs and health care resource utilization (HCRU) in patients ≥50 years, including those with comorbidities, as limited information exists in Italy.
This retrospective analysis used reimbursement data from local health authorities in Italy (January 2009-June 2022). Cases of HZ and PHN identified by International Classification of Diseases, Ninth Revision, Clinical Modification codes and drug prescriptions were characterized and followed up for 1 year before and after the index date. The direct HCRU costs for patients with HZ/PHN were compared with those for patients without HZ/PHN.
Of the total 193 259 patients with HZ/PHN identified (mean age, 61.6 years), 145 923 were ≥50 years old (immunocompromised: 29.9%; ≥1 chronic condition: 76.1%). During follow-up, 18.8% of patients ≥50 years of age with HZ progressed to PHN complications, and 3618 hospital admissions were reported (median length of stay, 9 days). Drug prescriptions and all-cause hospitalizations were the main contributors to total annual direct health care costs, estimated at M€272 for patients with HZ/PHN, whose burden increased with age. Higher health care costs were observed in patients with HZ/PHN vs patients without HZ/PHN. Moreover, average health care costs were up to 4× higher for patients with HZ and PHN compared with those without PHN.
HZ causes a significant economic impact on the health care system, driven mainly by high costs of medications and hospitalizations among older adults and those with comorbidities, particularly when complicated by PHN.
带状疱疹（HZ）感染风险随年龄增长和免疫抑制而增加。在意大利，由于相关信息有限，我们估计了HZ和带状疱疹后神经痛（PHN）对50岁及以上患者直接成本和医疗保健资源利用（HCRU）的影响，包括那些患有合并症的患者。
这项回顾性分析使用了意大利地方卫生当局的报销数据（2009年1月至2022年6月）。通过国际疾病分类第九版临床修订本代码和药物处方确定的HZ和PHN病例进行了特征描述，并在索引日期前后进行了1年的随访。将HZ/PHN患者的直接HCRU成本与无HZ/PHN患者的成本进行比较。
在总共193259例确诊的HZ/PHN患者中（平均年龄61.6岁），145923例年龄≥50岁（免疫功能低下者：29.9%；≥1种慢性病患者：76.1%）。在随访期间，50岁及以上的HZ患者中有18.8%进展为PHN并发症，报告了3618例住院病例（中位住院时间为9天）。药物处方和全因住院是年度直接医疗保健总成本的主要构成部分，HZ/PHN患者的估计总成本为2.72亿欧元，且负担随年龄增加。与无HZ/PHN的患者相比，HZ/PHN患者的医疗保健成本更高。此外，与无PHN的患者相比，HZ和PHN患者的平均医疗保健成本高出多达4倍。
HZ对医疗保健系统造成了重大经济影响，主要原因是老年人和合并症患者的药物和住院成本高昂，尤其是在并发PHN时。
