Modeling the herpes zoster disease burden and its potential health impact on older adults >50 years of age in Brazil

Abstract

In Brazil, as the older population has grown at a very rapid pace (by 57.4% over 2010), the number of herpes zoster (HZ) infections is expected to increase. As the Brazilian healthcare system constitutes a complex combination of public-private financing, estimating the true impact of HZ is challenging. The objective was to ascertain the disease burden of HZ and estimate its attributable cost in older adults aged ≥50 y who are users of public and private health services. Disease burden was estimated based on the ZOster ecoNomic Analysis model using Brazil-specific inputs, and any information gap was addressed by the Delphi Panel. The incidence estimates were multiplied by the cost per intervention to calculate the economic burden of the disease. In the absence of HZ vaccination, older adults ≥50 y are projected to experience 359,797 and 23,917 cases of HZ and post-herpetic neuralgia (PHN), with frequent and severe outcomes in the advanced age groups. The estimated mean cost of treatment per patient for HZ and PHN was ~7X and 16X more in the ANS population compared with the SUS. The number of hospitalizations (1339–1424) and median length of stay (4–5 d) were comparable between ANS and SUS. Hospitalization increased the treatment cost >10X (ANS: R$12459.67 –16,343.07; SUS: R$357.93 to 525.08). HZ imposes a substantial economic burden on the healthcare system due to high direct medical (R$357.36 million) and indirect costs (R$440.82 million). These results hold valuable insights for healthcare providers, insurers, and policymakers offering a comprehensive overview of the economic impact of HZ while implementing strategies for prevention of disease.