Incidence, resource use and costs associated with postherpetic neuralgia: a population-based retrospective study

Aim. To determine the incidence rate, the treatment administered and the use of health resources and health, and their respective costs in patients with postherpetic neuralgia (PHN). Patients and methods. We performed an observational design, made from retrospective review of patient records from six primary care centers and one hospital. All patients > 30 years consulting for PHN between 1/1/2007 and 31/12/2010 were included. Prepared two study groups according to presence / absence of PHN. Follow up was for one year. Main measures: socio-demographic, treatment and co-morbidity. The cost model differed direct healthcare costs (primary care/specialist) and indirect (productivity). Statistical analysis: logistic regression models and analysis of covariance (p < 0.05). Results. 1506 patients were recruited, age: 61.2 years female: 59.2%. 15.1% (n = 228, 95% Cl = 8.1-22.1%) had a PHN (incidence rate: 0.8/1,000 inhabitants/year; 95% Cl = 0.7-0.9/1,000 population/year), and increased with age (>= 65 years: 19.7%). The PHN was principally associated with: psychosis (OR = 3.9), dementia (OR = 2.3), depression (OR = 1.8) and age (OR = 1.1), p < 0.03. Drugs use was higher (5.3 vs. 3.3; p < 0.001). The cost in primary care was 63.1% and 24.7% indirect. Total cost (sic)1827.1 vs. (sic)457.5 (p = 0.003), respectively, due to higher labour productivity losses ((sic)692.2 vs. (sic)62.4) and health costs ((sic)1135 vs. (sic)395.1); p < 0.001. All cost components maintained these differences. Conclusions. PHN is a frequent complication. These patients have a significant economic burden. The cost increases with age.