title: Burden of herpes zoster and post-herpetic neuralgia in Sweden.
abstract: BACKGROUND
  The societal economic burden of herpes zoster in Sweden is not well described today. This study is a top-down analysis of Swedish registers with the objective to describe the burden of herpes zoster and post-herpetic neuralgia in Sweden during 2011.
  
  
  METHODS
  Data for inpatient care; outpatient primary and specialized cares; the prescriptions of drugs, sick leave and the number or diagnostic tests were collected from Swedish national databases. The incidence of the disease was estimated based on the number of prescriptions of antiviral drugs.
  
  
  RESULTS
  The incidence of herpes zoster was estimated to 315 and 577 cases per 100,000 people for patients at all ages and > = 50 years, respectively. Almost 30,000 patients at all ages were diagnosed with herpes zoster and the societal cost to treat these patients, including the cost to treat those patients who later developed post-herpetic neuralgia, added up to nearly 227 MSEK (31.6 M€) which corresponds to 7,600 SEK (€870) per patient. The main contributors to the total cost for the treatment of HZ patients were primary care (43 %); sick leave (28 %); hospitalization (10 %) and specialist care (7 %). Medication was a relatively small contributor with 8.5 MSEK (4 %; 1.0 M€) to the overall costs for patients at all ages. The corresponding total cost including only patients 50 years and older was 168 MSEK (19.2 M€) or 8,200 SEK (€939) per patient.
  
  
  CONCLUSIONS
  The current study demonstrates that the burden of herpes zoster is significant in Sweden. The society, the health care payers and the patients potentially have a lot to gain by introducing a vaccination program to patients 50 years and older and as a consequence reduce the economic and clinical burden of herpes zoster and post-herpetic neuralgia.
authors.affiliation: Mapi Group, Stockholm, Klarabergsviadukten 90D, SE-111 64, Stockholm, Sweden. Jonas.nilsson@optum.com.
authors.forename: Jonas
authors.initials: J
authors.lastname: Nilsson
authors.affiliation: Sanofi Pasteur MSD, Solna, Sweden. assel@spmsd.com.
authors.forename: Tobias
authors.initials: T
authors.lastname: Cassel
authors.affiliation: Karolinska Institutet, Department of Medicine, Huddinge, Sweden. Lars.Lindquist@ki.se.
authors.forename: Lars
authors.initials: L
authors.lastname: Lindquist
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000191:economics; D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003365:Costs and Cost Analysis; D016208:Databases, Factual; D006562:Herpes Zoster / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology; D006760:Hospitalization / Q000191:economics; D006801:Humans; D017589:Immunization Programs / Q000191:economics; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D051474:Neuralgia, Postherpetic / Q000150:complications / Q000191:economics* / Q000453:epidemiology; D018582:Sick Leave / Q000191:economics; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000998:Antiviral Agents