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Epidemiology and cost of herpes zoster and post-herpetic neuralgia in the United Kingdom

  • A. GAUTHIER (a1), J. BREUER (a2), D. CARRINGTON (a3), M. MARTIN (a1) and V. RÉMY (a4)...

Recent information on epidemiology and management of herpes zoster (HZ) and post-herpetic neuralgia (PHN), a painful complication of HZ, is scarce. The objective of this study was to document the burden of HZ and PHN in the United Kingdom. This retrospective analysis of the UK General Practice Research Database aimed to estimate HZ incidence and proportion of HZ patients developing PHN and to assess management costs in immunocompetent individuals aged ⩾50 years. A cohort of 27 225 HZ patients was selected, corresponding to an incidence of 5·23/1000 person-years. Respectively 19·5% and 13·7% of patients developed PHN at least 1 and 3 months after HZ diagnosis. Mean direct cost was £103 per HZ patient and £341 and £397 per PHN episode (1- and 3-month definition respectively). Both HZ and PHN costs increased markedly with pain severity. This study confirms that HZ and PHN are frequent and costly diseases in the United Kingdom.

Corresponding author
*Author for correspondence: A. Gauthier, i3 Innovus, 3rd floor, Beaufort House, Cricket Field Road, Uxbridge, Middlesex UB8 1QG, UK. Email:
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1. Oster G, et al. Pain, medication use, and health-related quality of life in older persons with postherpetic neuralgia: results from a population-based survey. Journal of Pain 2005; 6: 356363.
2. Johnson RW, Dworkin RH. Treatment of herpes zoster and postherpetic neuralgia. British Medical Journal 2003; 326: 748750.
3. Jung BF, et al. Risk factors for postherpetic neuralgia in patients with herpes zoster. Neurology 2004; 62: 15451551.
4. Schmader K. Epidemiology and impact on quality of life of postherpetic neuralgia and painful diabetic neuropathy. Clinical Journal of Pain 2002; 18: 350354.
5. Miller E, Marshall R, Vurdien J. Epidemiology, outcome and control of varicella-zoster infection. Reviews in Medical Microbiology, 1993; 4: 222230.
6. Brisson M, et al. Epidemiology of varicella zoster virus infection in Canada and in the United Kingdom. Epidemiology and Infection 2001; 27: 305314.
7. Cunningham AL, Dworkin RH. The management of post-herpetic neuralgia. British Medical Journal 2000; 321: 778779.
8. Donahue JG, et al. The incidence of herpes zoster. Archives of Internal Medicine 1995; 155: 16051609.
9. Bowsher D. The lifetime occurrence of herpes zoster and prevalence of postherpetic neuralgia: a retrospective survey in an elderly population. European Journal of Pain 1999; 3: 335342.
10. Edmunds J, Brisson M, Rose JD. The epidemiology of herpes zoster and potential cost-effectiveness of vaccination in England and Wales. Vaccine 2001; 19: 30763090.
11. Opstelten W, et al. Herpes zoster and postherpetic neuralgia: incidence and risk indicators using a general practice research database. Family Practice 2002; 19: 471475.
12. Scott FT, et al. The burden of Herpes Zoster: a prospective population based study. Vaccine 2006; 24: 13081314.
13. Hope-Simpson R. Postherpetic neuralgia. Journal of Royal College of General Practitioners 1975; 18: 2533.
14. Oxman MN, et al. A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. New England Journal of Medicine 2005; 352: 22712284.
16. Curtis L, Netten A. Unit Costs and Health and Social Services 2005. Personal Social Services Research Unit, 2005.
17. British National Formulary ( Accessed 20 June 2006.
19. UK National Statistics ( Accessed 20 June 2006.
20. Insinga R, et al. The incidence of Herpes Zoster in a United States Administrative Database. Journal of General Internal Medicine 2005; 230: 748753.
21. Thomas S, Hall A. What does epidemiology tell us about risk factors for herpes zoster? Lancet Infectious Diseases 2004; 4: 2633.
22. Bebbington A, Darton R, Netten A. Care homes for older people, volume 2. Admissions, needs and outcomes. The 1995/96 National Longitudinal Survey of Publicly-Funded Admissions PSSRU ( Accessed 13 February 2008.
23. Alper B, Lewis P. Does treatment of acute Herpes Zoster prevent or shorten postherpetic neuralgia? A systematic review of the literature. Family Practice 2000; 49: 255264.
24. Opstelten W et al. Gender as an independent risk factor for herpes zoster: a population-based prospective study. Annals of Epidemiology 2006; 16: 692695.
25. Fleming D, et al. Gender difference in the incidence of shingles. Epidemiology and Infection 2004; 132: 15.
26. Coplan PM, et al. Development of a measure of the burden of pain due to herpes zoster and postherpetic neuralgia for prevention trials: adaptation of the brief pain inventory. Journal of Pain 2004; 5: 344356.
27. Chidiac C, et al. Characteristics of patients with herpes zoster on presentation to practitioners in France. Clinical Infectious Diseases 2001; 33: 6269.
28. Davies L, et al. The cost of treatment for post-herpetic neuralgia in the UK. Pharmacoeconomics 1994; 6: 142148.
29. Katz J, et al. Acute pain in herpes zoster and its impact on health-related quality of life. Clinical Infectious Diseases 2004; 39: 342348.
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Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
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