The Cost of Treatment for Post-Herpetic Neuralgia in the UK

Abstract

Post-herpetic neuralgia (PHN) following acute shingles caused by the herpes simplex virus is a painful and often disabling condition. Treatment of the condition can involve a range of drug therapies. In addition, patients with continuing pain may make several visits to general practitioners and hospital outpatient departments. The costs of treatment for these patients may be substantial. The main objective of this study was to estimate the costs and consequences to the UK National Health Service (NHS) of the treatment of PHN following shingles, and the effect of the condition on patients' lives in terms of pain and time off usual activities such as work. The lifetime direct treatment costs of a cohort of people from onset of PHN to resolution of the disease or death were calculated. These costs were estimated from data on the type and quantity of health resources used, and the unit costs or prices of those resources. This study has shown that PHN can be a costly consequence of acute shingles. For patients attending a tertiary referral centre the lifetime cost was 770 British pounds sterling. For a 1-year incidence cohort of people with shingles in the UK, the lifetime costs of treating PHN are between 4.8 million British pounds sterling (incidence of 21 000 people) and 17.9 million British pounds sterling (incidence of 78 200 people). Efforts are needed to reduce the incidence or severity of PHN.(ABSTRACT TRUNCATED AT 250 WORDS)

The Epidemiological, Clinical, and Pathological Rationale for the Herpes Zoster Vaccine

“…In a mailed questionnaire study of older adults with PHN ( ) recruited via advertisements in 24 US n p 385 newspapers, pain interference with general activity, mean ‫ע‬ SD mood, relations with other people, sleep, and enjoyment of life (0-10 point scale) was , , , 3.7 ‫ע‬ 3.1 4.3 ‫ע‬ 2.9 3.0 ‫ע‬ 2.8 3.8 ‫ע‬ , and , respectively, and the mean EQ-5D health 2.9 4.5 ‫ע‬ 3.1 index score was 0.61 [39]. In a pain clinic in Liverpool, England, 59% of patients with PHN were prevented from pursuing their usual activities for up to 16 years, with the average being 1.4 years [40].…”

Brain dynamics for perception of tactile allodynia (touch-induced pain) in postherpetic neuralgia

“…Postherpetic neuralgia (PHN) is estimated to occur in 2-35% of subjects after reactivation of latent varicella-zoster virus [13,31,[36][37][38].It is characterized by the presence of pain of various qualities: 1) continuous burning or aching pain, 2) intermittent sharp pain, and 3) various sensory complaints, and is commonly accompanied by touch provoking a perception of pain (tactile allodynia, estimated incidence of 70-90%) [21][22][23]26,56] Even though PHN often resolves with time, in some patients the pain persists for years, usually with a devastating impact on quality of life [18]. The condition is considered the prototypical human chronic neuropathic condition, because such patients exhibit multiple peripheral and central signs of neuropathy [49,50,63], yet there is very little information regarding the brain mechanisms involved in the condition, especially for tactile allodynia.…”

Treatment Parameters for the Successful Management of Varicella Zoster Virus

“…Fiddian, Wellcome Foundation, personal communication). If these findings are confirmed, then the cost-benefit ratio would seem very favourable, particularly as the mean lifetime cost of treating an episode of PHN conventionally has been estimated at £770 (Davies et al, 1994). In this study, the mean cost of treatment, however, ranged from as low as £31 to as high as £11,811; the cost components included drug therapy (mainly tricyclics; 42% of total), consultation at a pain clinic (23% of total) and community care and support.…”