OBJECTIVES: Herpes Zoster (HZ) risk of infection increases with age and immunocompromised (IC) status due to underlying treatment or condition. HZ and post-herpetic neuralgia (PHN) generate considerable clinical and economic burdens. We estimated healthcare resource utilization and direct costs among HZ or/and PHN patients, in general adults, and adults with comorbidities, in Italy.

METHODS: We conducted an observational retrospective analysis using reimbursement data from a pool of Italian local health authorities. Data between 01/2009 and 06/2022 were analyzed, covering approximately 20% of the Italian population. Adult patients were characterized and followed-up during at least one year 1-period before and after the index-date (first HZ/PHN hospitalization or HZ brivudine prescription). Direct healthcare costs were estimated in the overall adult HZ/PHN population and compared to non-HZ/PHN adults. Sub-group analyses were performed for older adults (≥50 years), IC adults, adults with chronic diseases, and adults with cancers.

RESULTS: Among 193,259 HZ/PHN included adults (mean age 61.6 years), 145,923 were ≥50 years old; of them, 29.9% were IC and 76.1% had ≥1 chronic condition. Among the 3,618 patients aged ≥50 years included by hospitalization, the observed mean length of stay was of 18.3 days. During the 1-year follow-up, 18.8% of patients aged ≥50 years developed PHN complications. Total mean annual healthcare costs (adjusted for the 2022 inflation rate) following HZ/PHN diagnosis was estimated at 272M€; costs were observed to increase with age; 1,050€ (50-59 years), 1,382€ (60-64 years), 1,780€ (65-69 years), 2,327€ (70-79 years), 2,631€ (≥80 years), and mainly driven by drug prescriptions and all-cause hospitalizations. Among overall adults, higher healthcare costs were observed in HZ/PHN patients with IC condition, or with chronic diseases, or with cancers, when compared to their non-HZ/PHN counterparts.

CONCLUSIONS: This real-world analysis showed that HZ poses a substantial economic burden in older adults and individuals with comorbidities, in Italy.