title: Prophylactic Efficacy Against Herpes Zoster and Costs Difference Between Acyclovir and Valaciclovir in Hematological Patients.
abstract: BACKGROUND
  Immunocompromised hematological patients are at increased risk of herpes zoster (HZ). We examined the efficacy of acyclovir and valaciclovir in preventing HZ. We also created a simulation to reduce prophylactic medicine costs.
  
  
  METHODS
  We retrospectively evaluated 573 hematological patients who received chemotherapy, and assessed the difference in the costs between the acyclovir (Zovirax®) and valaciclovir (Valtrex®) groups.
  
  
  RESULTS
  Forty-four out of the 573 patients (7.7%) developed HZ. Out of them, there were 37 patients (84.1%) who received corticosteroids. Moreover, in total, there were 67 patients receiving acyclovir prophylaxis and 42 patients receiving valaciclovir prophylaxis, out of which one from each group occurred with HZ. The total 5-year cost of acyclovir and valaciclovir was ¥2,869,917 and ¥4,809,952, respectively. Therefore, by changing from valaciclovir to acyclovir, medical costs could be reduced by 28.3%. Additionally, switching to generic inexpensive acyclovir would possibly reduce them to 15.0%.
  
  
  CONCLUSIONS
  Chemotherapy, including corticosteroids, is associated with a high incidence of HZ. Additionally, there was no prophylactic difference between acyclovir and valaciclovir. We expect that use of generic acyclovir could reduce prophylaxis costs by 85.0%.
authors: Department of Pharmacy, Ogaki Municipal Hospital, Gifu, Japan omhp2002@yahoo.co.jp.
authors: Eiseki
authors: E
authors: Usami
authors: Department of Pharmacy, Ogaki Municipal Hospital, Gifu, Japan.
authors: Michio
authors: M
authors: Kimura
authors: Department of Pharmacy, Ogaki Municipal Hospital, Gifu, Japan.
authors: Mina
authors: M
authors: Iwai
authors: Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Japan.
authors: Hitomi
authors: H
authors: Teramachi
authors: Department of Pharmacy, Ogaki Municipal Hospital, Gifu, Japan.
authors: Tomoaki
authors: T
authors: Yoshimura
mesh_terms: D000212:Acyclovir / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology / Q000821:virology; D006562:Herpes Zoster / Q000150:complications / Q000188:drug therapy* / Q000191:economics / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077483:Valacyclovir; D014633:Valine / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use
chemical_list: D014633:Valine; D000077483:Valacyclovir; D000212:Acyclovir
keywords: Herpes zoster; acyclovir; prophylactic medicine costs; valaciclovir