ABSTRACT

Objectives: Immunocompromised subjects are at increased risk for herpes zoster (HZ) and HZ-related complications, such as post-herpetic neuralgia (PHN). We describe health utilities, health care resource utilization (HCRU), productivity loss and health care costs in recipients of autologous hematopoietic stem-cell transplantation (Auto-HSCT) who developed confirmed HZ in the phase 3 clinical trial.

Methods: HCRU, costs, and EQ-5D-3L utility were assessed for 155 confirmed HZ cases observed after receiving inactivated varicella-zoster virus (VZV) vaccine (ZV_IN) or placebo. In a prospective, longitudinal 6-month follow up, costs and utilities were analyzed for two health states, HZ without PHN and HZ with PHN.

Results: There was a clinically relevant difference in utility between HZ without PHN (mean 0.814) and HZ with PHN (0.729). The disutility for HZ without PHN was estimated to −0.117 and to −0.186 for HZ with PHN. Direct costs (2017 USD) associated with a HZ without PHN episode and HZ with PHN episode was estimated at $3,412 and $3,711, respectively, of which hospitalizations accounted for 90% of the costs.

Expert opinion: Both HZ and PHN are associated with considerable disutility in recipients of Auto-HSCT. Costs were comparable to published estimates in other immunocompromised subjects.

The trial is registered at ClinicalTrials.gov (CT.gov identifier: NCT01229267).

摘要

目的：免疫受损的受试者患带状疱疹（HZ）和与HZ相关的并发症（如疱疹后神经痛（PHN））的风险增加。我们描述了自体造血干细胞移植（Auto-HSCT）接受者的健康效用，医疗保健资源利用（HCRU），生产力损失和医疗保健费用，这些接受者在3期临床试验中确定了HZ。

方法：对155例确诊的HZ病例在接受灭活的水痘带状疱疹病毒（VZV）疫苗（ZV _IN）或安慰剂后进行评估，评估其HCRU，费用和EQ-5D-3L效用。在为期六个月的前瞻性纵向随访中，分析了两种健康状态的成本和效用，即没有PHN的HZ和带有PHN的HZ。

结果：没有PHN的HZ（平均0.814）和带有PHN的HZ（0.729）之间的效用存在临床相关差异。对于没有PHN的HZ，其无效性估计为-0.117，对于带有PHN的HZ，其无效性估计为-0.186。与没有PHN发作的HZ和带有PHN发作的HZ相关的直接费用（2017美元）分别估计为$ 3,412和$ 3,711，其中住院占费用的90％。

专家意见： HZ和PHN都与Auto-HSCT接收者的相当大的无用功有关。在其他免疫功能低下的受试者中，费用与已公布的估计值相当。

该试验已在ClinicalTrials.gov（CT.gov标识符：NCT01229267）上注册。