Healthcare utilization and costs among patients with herpes zoster and solid tumor malignancy on chemotherapy
نویسندگان
چکیده
Immunosuppressed patients with solid tumor malignancies (STMs) are particularly vulnerable to herpes zoster (HZ). This study estimated the incidence of HZ and evaluated healthcare resource utilization and costs for persons with STM receiving chemotherapy with and without incident HZ.We conducted a retrospective claims study of adults with STM receiving chemotherapy between January 1, 2010 and June 30, 2014. Patients were followed from their first chemotherapy date through development of HZ, health plan disenrollment, the study end date, or 24 months. HZ incidence was calculated and stratified by patient characteristics. Adjusted HZ incidence was estimated using Poisson regression. Healthcare resource utilization and costs were compared between patients with HZ (cases) and propensity score-matched controls without HZ during a variable follow-up period. Adjusted healthcare costs were estimated using Lin regression to control for informative censoring.Of 155,480 patients with STM receiving chemotherapy, 3100 (2.0%) developed HZ, yielding an adjusted HZ incidence rate of 13.8/1000 person-years (PY). HZ cases (n = 3004) had significantly higher healthcare resource utilization than matched controls (n = 15,020). Adjusted annual costs were $48,077 for cases vs $41,645 for matched controls, corresponding to a differential cost of $6432 annually.After adjustment for potential confounders, patients with STM receiving chemotherapy had an HZ incidence of 13.8/1000 PY; those who developed HZ used more healthcare resources and incurred higher costs than those who did not. These findings suggest that HZ prevention by vaccination could improve outcomes and reduce costs in this population.
منابع مشابه
Cost of Herpes Zoster in Patients With Selected Immune-Compromised Conditions in the United States
Background. This retrospective study investigates the healthcare costs of herpes zoster (HZ) in patients with selected immune-compromised (IC) conditions in the United States (US). Methods. Patients with incident HZ diagnosis (index date) were selected from nationwide administrative claims databases from 2005 to 2009. Baseline IC groups, analyzed separately, included adults aged 18-64 years w...
متن کاملEpidemiology and long-term disease burden of herpes zoster and postherpetic neuralgia in Taiwan: a population-based, propensity score-matched cohort study
BACKGROUND The objectives of this study were to characterize the burden of herpes zoster, as well as the longitudinal and incremental changes of healthcare service utilization among individuals with herpes zoster and postherpetic neuralgia (PHN) compared to those without. METHODS Using the National Health Insurance Research Database (NHIRD), we established a herpes zoster cohort of people dia...
متن کاملبررسی بروز سرطان ثانویه پس از درمان بیماران مبتلا به لنفوم هوچکین در بیمارستان حضرت علیاصغر(ع)
Hodgkin’s disease is one of the most common childhood malignancies that with correct diagnosis and effective treatment is curable and without treatment is leading to death. The survival of patients with Hodgkin’s disease has dramatically improved over the past 30 years because of advances in treatment. However, concern for the risk of long tern complications has resulted in a number of tria...
متن کاملIncidence, risk factors and prevention of herpes zoster: review article
Herpes zoster (Shingles; Zona) is an acute infectious skin disease that is caused by the reactivation of varicella zoster virus (VZV). After the initial infection (chickenpox) or vaccination, the virus remains inactive or latent in the dorsal root ganglia (DRG); when decreasing cell mediated immunity (CMI) occurs, the virus is reactivated from a latent phase to a lytic phase and frequently repl...
متن کامل