title: Healthcare resource utilization and costs associated with herpes zoster in the US.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: a Truven Health Analytics , Ann Arbor , MI , USA ;
authors.forename: Barbara H
authors.initials: BH
authors.lastname: Johnson
authors.affiliation: a Truven Health Analytics , Ann Arbor , MI , USA ;
authors.forename: Liisa
authors.initials: L
authors.lastname: Palmer
authors.affiliation: b University of Tennessee Health Science Center College of Pharmacy , Nashville , TN , USA ;
authors.forename: Justin
authors.initials: J
authors.lastname: Gatwood
authors.affiliation: a Truven Health Analytics , Ann Arbor , MI , USA ;
authors.forename: Gregory
authors.initials: G
authors.lastname: Lenhart
authors.affiliation: c Clinical Research Center , Boston Children's Hospital; Harvard Medical School , Boston , MA , USA ;
authors.forename: Kosuke
authors.initials: K
authors.lastname: Kawai
authors.affiliation: d Center for Observational and Real-World Evidence , Merck & Co., Inc. , Kenilworth , NJ , USA.
authors.forename: Camilo J
authors.initials: CJ
authors.lastname: Acosta
mesh_terms: D000328:Adult; D000368:Aged; D016208:Databases, Factual; D005260:Female; D017048:Health Care Costs; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D006562:Herpes Zoster / Q000191:economics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014481:United States
keywords: Herpes zoster; PHN; administrative claims data; case control; healthcare resource utilization and costs; immunocompetent population