The Cost of Treatment for Post-Herpetic Neuralgia in the UK

Summary

Post-herpetic neuralgia (PHN) following acute shingles caused by the herpes simplex virus is a painful and often disabling condition. Treatment of the condition can involve a range of drug therapies. In addition, patients with continuing pain may make several visits to general practitioners and hospital outpatient departments. The costs of treatment for these patients may be substantial.

The main objective of this study was to estimate the costs and consequences to the UK National Health Service (NHS) of the treatment of PHN following shingles, and the effect of the condition on patients’ lives in terms of pain and time off usual activities such as work. The lifetime direct treatment costs of a cohort of people from onset of PHN to resolution of the disease or death were calculated. These costs were estimated from data on the type and quantity of health resources used, and the unit costs or prices of those resources.

This study has shown that PHN can be a costly consequence of acute shingles. For patients attending a tertiary referral centre the lifetime cost was £770. For a 1-year incidence cohort of people with shingles in the UK, the lifetime costs of treating PHN are between £4.8 million (incidence of 21 000 people) and £17.9 million (incidence of 78 200 people).

Efforts are needed to reduce the incidence or severity of PHN. If antiviral therapy can be shown to reduce this incidence, the costs estimated in this study should form part of the overall cost-benefit equation for the treatment of acute shingles.