The European Journal of Health Economics

, Volume 14, Issue 6, pp 1015–1026

Epidemiology and cost of herpes zoster and postherpetic neuralgia in Germany

  • Bernhard Ultsch
  • Ingrid Köster
  • Thomas Reinhold
  • Anette Siedler
  • Gérard Krause
  • Andrea Icks
  • Ingrid Schubert
  • Ole Wichmann
Original Paper

DOI: 10.1007/s10198-012-0452-1

Cite this article as:
Ultsch, B., Köster, I., Reinhold, T. et al. Eur J Health Econ (2013) 14: 1015. doi:10.1007/s10198-012-0452-1

Abstract

After acquiring a varicella virus infection, the virus can reactivate and cause herpes zoster (HZ)—a painful skin rash. A complication of HZ is long-term persistence of pain after the rash has resolved (so-called postherpetic neuralgia, PHN). We aimed to describe the epidemiology of HZ/PHN and to estimate HZ/PHN-related costs in the German statutory health insurance (SHI) system (~85 % of the total population). Treatment data of one large SHI was utilized, containing data on approximately 240,000 insured and their utilisation of services in 2004–2009. Identification of HZ- and PHN-cases was performed based on ‘International Statistical Classification of Diseases’ and specific medications using a control-group design. Incidences per 1,000 person-years (PY) and cost-of-illness for 1 year following HZ-onset considering the payer and societal perspective were calculated. All amounts were inflated to 2010 Euros. Population-figures were standardised and extrapolated to the total SHI-population in Germany in 2010. A mean annual incidence of 5.79 HZ-cases per 1,000 PY was observed, translating into an estimated 403,625 HZ-cases per year in the total SHI-population. Approximately 5 % of HZ-cases developed PHN. One HZ-case caused on average €210 and €376 of costs from the payer and societal perspective, respectively. The development of PHN generated additional costs of €1,123 (€1,645 societal perspective). Total annual HZ/PHN-related costs were estimated at €182 million (€105 million) to society (payer). HZ and PHN place a considerable burden on the German SHI-system. Since HZ-vaccines will soon be available, a health-economic evaluation of these vaccines should be conducted.

Keywords

Herpes zosterPostherpetic neuralgiaEpidemiologyCost of illnessGermany

JEL Classification

C81I11I13I19J14

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Bernhard Ultsch
    • 1
    • 2
  • Ingrid Köster
    • 3
  • Thomas Reinhold
    • 4
  • Anette Siedler
    • 1
  • Gérard Krause
    • 5
    • 6
  • Andrea Icks
    • 7
  • Ingrid Schubert
    • 3
  • Ole Wichmann
    • 1
  1. 1.Immunisation Unit, Department for Infectious Disease EpidemiologyRobert Koch InstituteBerlinGermany
  2. 2.CharitéUniversity Medical CentreBerlinGermany
  3. 3.PMV Research GroupUniversity of CologneCologneGermany
  4. 4.Institute for Social Medicine, Epidemiology and Health Economics, CharitéUniversity Medical CentreBerlinGermany
  5. 5.Department for Infectious Disease EpidemiologyRobert Koch InstituteBerlinGermany
  6. 6.Department for EpidemiologyHelmholtz Centre for Infection ResearchBraunschweigGermany
  7. 7.Institute for Biometry and Epidemiology at the German Diabetes-CenterHeinrich Heine UniversityDüsseldorfGermany