OBJECTIVE: This analysis (GSK study identifier: HO-15-15772) assessed costs associated with diagnosed herpes zoster (HZ)-related complications using a US insurance claims database.
METHODS: Patients with a diagnosis of HZ (ICD-9-CM diagnosis code 053.xx) between 04/01/2008 and 03/31/2013 were selected from the Truven Health MarketScan Research Database (the date of the first observed HZ diagnosis was designated as the index date). Patients were required to be ≥50 years and to have continuous health plan enrolment 6 months pre- through 12 months post-index date. Cutaneous, neurologic (excluding post-herpetic neuralgia), and ophthalmic HZrelated complications were identified using ICD-9-CM codes. Patients with immunodeficiency diagnoses or who received an HZ vaccine pre-index date were excluded. Healthcare costs were assessed in the 1-year time-frame post-index date; post-hoc multivariable regression models using a tightened definition of ophthalmic complications (neurologic and cutaneous definitions remained unchanged) controlled for demographics, pre-index date costs, and comorbidities.
RESULTS: Of 248,275 patients with HZ, 9.7% had a complication (5,452 cutaneous, 1,076 neurologic, 17,289 ophthalmic). Patients with a complication accrued $4,716 more in unadjusted all-cause total healthcare costs, on average, versus patients without complications (range: $2,173 ophthalmic to $18,323 neurologic). Costs associated with a complication tended to increase with age (range: $2,925 ages 50-59 to $5,923 ages 70-79). Multivariable models demonstrated that patients with a cutaneous complication accrued $5,491, patients with a neurological complication accrued $10,866, and patients with an ophthalmic complication accrued $784 greater costs versus patients without complications.
CONCLUSIONS: Costs associated with diagnosed HZ-related complications are substantial and tend to increase with age.