Measuring herpes zoster, zoster‐associated pain, post‐herpetic neuralgia‐associated loss of quality of life, and healthcare utilization and costs in Thailand

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Abstract
Objectives  This study aimed to measure the herpes zoster‐associated burden of illness, healthcare utilization, and costs among Thai patients.Methods  This prospective cohort study of 180 patients aged ≥ 50 years and healthy, or ≥ 20 years and immunosuppressed, with zoster rash, was conducted in Bangkok and its environs, Thailand, during 2007–2008. Each patient was followed for six months for zoster‐associated rash, pain, quality of life (QoL), and healthcare utilization and costs.Results  A total of 180 subjects were enrolled in the study. Their mean ± standard deviation (SD) age was 58.9 ± 13.8 years. Of the 180 patients enrolled, 138 (76.7%), 34 (18.9%) and eight (4.4%) patients were elderly, HIV‐infected, and receiving immunosuppressive agents, respectively; 35 (19.4%) had post‐herpetic neuralgia (PHN), and 13 (7.2%) had zoster ophthalmicus. The severity of zoster pain was moderately highly correlated with activities of daily living (ADL), at 0.68 ≤ ρ ≤ 0.76. Most patients required only one or two outpatient visits. The mean ± SD total of direct healthcare costs was 3083.4 ± 5047.0 Thai baht or ∼ 1.1% of annual income per capita.Conclusions  Herpes zoster contributes a significant burden of illness to both patients and the wider community.