Epidemiologic, health care resource use and economic parameters
| Parameter by age category, yr | Base value | Minimum | Maximum | References |
|---|---|---|---|---|
| Epidemiologic | ||||
| Herpes zoster incidence, per 1000 person-years | Brisson et al., (21) Letellier et al., (25) Russell et al., (26) Tanuseputro et al., (27) Marra et al. (28) | |||
| 50–54 | 3.8 | 3.5 (25)¶ | 4.2 (26) | |
| 55–64 | 6 | 5.1 (25)¶ | 6.9 (26) | |
| 65–74 | 8.6 | 7.3 (25)¶ | 10.0 (26) | |
| ≥ 75 | 9.9 | 8.0 (25)¶ | 11.8 (26) | |
| Postherpetic neuralgia,* % of herpes zoster cases | Oxman et al., (10) Brisson et al. (21) | |||
| 50–54 | 9.4 | 6.9 (21) | 11.9 (21) | |
| 55–64 | 9.4 | 6.9 (21) | 11.9 (21) | |
| 65–74 | 26 | 18.5 (21) | 33.4 (21) | |
| ≥ 75 | 27.7 | 22.0 (21) | 33.4 (21) | |
| Case-fatality rate, %† | Edmunds et al., (4) Brisson et al. (21) | |||
| 50–54 | 0 | 0.000 (21) | 0.002 (21) | |
| 55–64 | 0 | 0.000 (21) | 0.002 (21) | |
| 65–74 | 0.012 | 0.012 (21) | 0.083 (21) | |
| ≥ 75 | 0.076 | 0.040 (21) | 0.083 (21) | |
| Health care resource use | ||||
| Hospitalization, % of herpes zoster cases | Brisson et al., (3) Brisson et al., (21) Letellier et al., (25) Tanuseputro et al. (27) | |||
| 50–54 | 1.1 | 0.5 (21) | 1.6 (21) | |
| 55–64 | 1.6 | 0.7 (21) | 2.5 (21) | |
| 65–74 | 3.3 | 1.5 (21) | 5.1 (21) | |
| ≥ 75 | 9.9 | 4.1 (21) | 15.6 (21) | |
| Consultations, per herpes zoster case | Brisson et al., (21) Letellier et al., (25) Najafzadeh et al. (29) | |||
| 50–54 | 1.7 | 1.0 (21) | 2.4 (21) | |
| 55–64 | 2 | 1.0 (21) | 2.9 (21) | |
| 65–74 | 2.3 | 1.0 (21) | 3.5 (21) | |
| ≥ 75 | 2.6 | 1.0 (21) | 4.2 (21) | |
| Length of hospital stay, d, mean | Brisson et al., (21) Letellier et al., (25) Najafzadeh et al. (29) | |||
| 50–54 | 9.3 | 5.8 (21) | 12.7 (21) | |
| 55–64 | 11.1 | 6.2 (21) | 14.7 (29) | |
| 65–74 | 12.6 | 8.3 (21) | 16.5 (29) | |
| ≥ 75 | 18 | 12.4 (21) | 23.7 (29) | |
| Costs,‡ in 2018 Can$ | ||||
| Herpes zoster–related hospitalization, per day | 918 (30) | 495 (21) | 1483 (21) | Brisson et al., (21) Najafzadeh et al., (29) Friesen et al. (30) |
| Herpes zoster–related consultations | 28 (30) | 24 (30) | 113 (29) | Brisson et al., (21) Najafzadeh et al., (29) Friesen et al. (30) |
| Treatment per herpes zoster episode | 136 (30) | 55 (21) | 255 (29) | Brisson et al., (21) Najafzadeh et al., (29) Friesen et al. (30) |
| Treatment per postherpetic neuralgia episode | 1588 (30) | 969 (30) | 2707 (21) | Brisson et al., (21) Najafzadeh et al., (29) Friesen et al. (30) |
| QALYs lost§ | ||||
| Herpes zoster | Drolet et al., (11) Brisson et al., (21) Brisson et al. (31) | |||
| 50–59 | 0.009 | 0.006 (31) | 0.012 (31) | |
| 60–69 | 0.01 | 0.006 (31) | 0.013 (31) | |
| ≥ 70 | 0.01 | 0.007 (31) | 0.014 (31) | |
| Postherpetic neuralgia | Drolet et al., (11) Brisson et al., (21) Brisson et al. (31) | |||
| 50–59 | 0.041 | 0.032 (31) | 0.052 (31) | |
| 60–69 | 0.192 | 0.103 (31) | 0.290 (31) | |
| ≥ 70 | 0.234 | 0.191 (31) | 0.290 (31) |
Note: base value = mean of minimum and maximum values identified in literature, maximum = maximum values identified in literature, minimum = minimum values identified in literature, QALY = quality-adjusted life-year.
↵* Postherpetic neuralgia was defined as clinically significant pain persisting for more than 90 days after onset of rash.
↵† Given the scarcity of data on herpes zoster–related mortality in Canada, we used case-fatality values estimated in a previous study in England and Wales. (4)
↵‡ Values from Friesen and colleagues (30) were used as the base values.
↵§ This variable captures, in a single measure, morbidity and mortality associated with a disease. Data for QALYs lost were obtained by measuring QALY-weight (or disutility), ranging from 0 to 1, where a weight of 1 corresponds to optimal health and a weight of 0 corresponds to a health state judged as equivalent to death. The QALY lost per case is the difference in QALY weights with and without the disease, multiplied by duration of the disease. The QALY weights were taken from MASTER, a pan-Canadian, multicentre 6-month prospective study, which recruited patients aged ≥ 50 years who presented with herpes zoster or postherpetic neuralgia, as described by Drolet and colleagues (11) and Brisson and colleagues. (31) Calculation of QALY lost is explained in detail by Brisson and colleagues. (21)
↵¶ Letellier and colleages (25) did not present data by specific age groups, but we had access to the original data from Quebec administrative databases (2001 to 2015); for the purposes of our analysis, we estimated the incidence of herpes zoster by age groups.