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. 2019 Sep 3:11:539-550.
doi: 10.2147/CEOR.S203920. eCollection 2019.

Patient and economic burdens of postherpetic neuralgia in China

Affiliations

Patient and economic burdens of postherpetic neuralgia in China

Sheng-Yuan Yu et al. Clinicoecon Outcomes Res. .

Abstract

Background: Little is known about the patient-reported and economic burdens of postherpetic neuralgia (PHN) among China's urban population.

Methods: This noninterventional study was conducted among adults ≥40 years with PHN who were seeking medical care at eight urban hospitals in China. At one study site, patients completed a questionnaire evaluating the patient-reported disease burden (N=185). The questionnaire consisted of validated patient-reported outcomes including the Brief Pain Inventory (BPI), 5-dimension, 3-level EuroQol (EQ-5D-3L), Medical Outcomes Study Sleep Scale, and Work Productivity and Activity Impairment Questionnaire for Specific Health Problems. Questions on non-pharmacologic therapy and out-of-pocket (OOP) expenses were also included. At all study sites, physicians (N=100) completed a structured review of patient charts (N=828), which was used to derive health care resource utilization and associated costs from the societal perspective. Annual costs in Chinese Yuan Renminbi (RMB) for the year 2016 were converted to US dollars (US$).

Results: Patients (N=185, mean age 63.0 years, 53.5% female) reported pain of moderate severity (mean BPI score 4.6); poor sleep quantity (average of 5.3 hrs per night) and quality; and poorer health status on the EQ-5D-3L relative to the general Chinese population. Respondents also reported average annual OOP costs of RMB 16,873 (US$2541) per patient, mainly for prescription PHN medications (RMB 8990 [US$1354]). Substantial work impairment among employed individuals resulted in annual indirect costs of RMB 28,025 (US$4221). In the chart review, physicians reported that patients (N=828) had substantial health resource utilization, especially office visits; 98% had all-cause and 95% had PHN-related office visits. Total annual direct medical costs were RMB 10,002 (US$1507), mostly driven by hospitalizations (RMB 8781 [US$1323]).

Conclusion: In urban China, PHN is associated with a patient-reported burden, affecting sleep, quality-of-life, and daily activities including work impairment, and an economic burden resulting from direct medical costs and indirect costs due to lost productivity. These burdens suggest the need for appropriate prevention and management of PHN.

Keywords: China; EQ-5D; disease burden; health care costs; health-related quality-of-life; postherpetic neuralgia; productivity.

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Conflict of interest statement

Marco DiBonaventura (an employee of Kantar Health at the time this study was conducted), Yu-Xuan Chen, Patrick Hlavacek, Markay Hopps, Margarita Udall, Alesia Sadosky, and Joseph C Cappelleri are employees of Pfizer and have stock options in Pfizer. Kristen Concialdi and Ian Kudel are employees of Kantar Health, who were paid consultants to Pfizer in relation to this study. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Sleep problems as indicated by time to sleep initiation (A) and subscale scores (B) on the Medical Outcomes Study Sleep Scale (MOS-SS) among patients diagnosed with postherpetic neuralgia who participated in the survey. Higher scores indicate poorer sleep quality except on the Sleep adequacy subscale. For reference in (B), general population norms for the US population (data from reference Hays RD et al.29) are shown as black horizontal bars, since normative values have not been established for the Chinese population.
Figure 2
Figure 2
Self-reported work and activity impairment resulting from postherpetic neuralgia assessed using Work Productivity and Activity Impairment Questionnaire for Specific Health Problems (WPAI:SHP).
Figure 3
Figure 3
Medications used by patients to treat postherpetic neuralgia. Abbreviations: SNRIs, serotonin-norepinephrine reuptake inhibitors; SSRI, selective serotonin reuptake inhibitors; TCAs, tricyclic antidepressants.

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