Health care expenditure burden of persisting herpes zoster pain

Objectives. Pain can persist long after the resolution of herpes zoster, but little is known regarding its health care costs. The objective of this study was to determine the health care expenditures associated with persisting pain following herpes zoster by comparing expenditures for patients with postherpetic neuralgia or subacute herpetic neuralgia with a control group without these conditions. Methods. Health care expenditures attributable to persisting pain in herpes zoster patients were calculated using Thomson-Medstat's MarketScan (R) databases to examine commercial, Medicare, and Medicaid claims for inpatient and outpatient services and outpatient prescription drugs. Results. Excess annualized costs were $4,917 for commercially insured patients, $2,696 for Medicare patients, and $9,310 for Medicaid patients. Conclusions. The substantial health care costs associated with persisting pain in herpes zoster have important public health implications given evidence that the incidence of herpes zoster is increasing and that the population is aging in the United States. The results provide a basis for evaluating the cost-effectiveness of existing treatments and emerging prevention strategies.