OBJECTIVES: This study aimed to investigate potential disease deterioration for underlying conditions (UCs: chronic obstructive pulmonary disease, diabetes mellitus type 1 or 2, depression, coronary heart disease, chronic heart failure (CHF), and rheumatoid arthritis) after an acute herpes zoster (HZ) using health care resource utilization (HCRU) and disease-specific worsening indicators.

METHODS: Analyses were based on claims data, representing 13% of the German statutory health insurance population (corresponding to 87% of the entire German population). Patients aged ≥18 years with UCs were included when an incident HZ-diagnosis (defined by International Classification of Diseases and prescription of an antiviral drug) was observed between 2008-2016. Patients were matched to controls with the same UC but without HZ in the observational period using propensity scores. HCRU was analyzed for four quarters prior and eight quarters after acute HZ. Regression models were used to identify potential excess HCRU and disease-specific worsening indicators in the post-acute quarters.

RESULTS: Over the observational period, HCRU data from 172,093 HZ patients, matched to 172,093 controls, were analyzed. Matching achieved almost perfect balance, as there was no significant difference for 12 out of 13 matching variables. Excess costs were observed in the index quarter of acute HZ for all UCs (range: €92-€259). A significant increase in post-acute excess costs was observed for patients with CHF only, amounting to 8.56% (152€) and 6.61% (114€) in the first and second quarter after HZ-incidence, respectively. Disease-specific worsening indicators were observed only for patients with depression who showed somatoform disorders excess diagnosis and excess antidepressant use in post-acute quarters.

CONCLUSIONS: HZ-incidence is associated with a significant increase in excess HCRU in the index quarter of HZ-diagnosis for patients with UCs. The present results suggest that deterioration of UCs more than 6 months after incident HZ is relevant for patients with CHF and depression.