Community and Patient Values for Preventing Herpes Zoster

Autor: Irene M. Shui, Donna Rusinak, Ken Kleinman, Rafael Harpaz, W. Katherine Yih, Ismael R. Ortega-Sanchez, Peter W. Choo, G. Thomas Ray, Lisa A. Prosser, Tracy A. Lieu
Rok vydání: 2008
Předmět:
Male
Herpesvirus 3
Human

Value of Life
medicine.medical_specialty
Time Factors
Multivariate analysis
Patients
Cost effectiveness
Cross-sectional study
Cost-Benefit Analysis
Neuralgia
Postherpetic

jel:D
jel:C
Herpes Zoster
jel:I
Contingent-valuation
Herpes-zoster
Postherpetic-neuralgia
Utility-measurement
Varicella-zoster-virus-vaccine-live
Willingness-to-pay

jel:I1
Surveys and Questionnaires
Herpes Zoster Vaccine
Humans
Medicine
Aged
Worst Imaginable Pain
Aged
80 and over

Pharmacology
Internet
jel:Z
business.industry
Postherpetic neuralgia
Health Policy
Public health
Public Health
Environmental and Occupational Health

Middle Aged
medicine.disease
jel:I11
Community-Institutional Relations
United States
Telephone
Surgery
Quality-adjusted life year
Cross-Sectional Studies
Attitude
jel:I18
jel:I19
Female
Quality-Adjusted Life Years
business
Shingles
Demography
Zdroj: PharmacoEconomics. 26(3):235-249
Popis: The US Advisory Committee on Immunization Practices has recently recommended a new vaccine against herpes zoster (shingles) for routine use in adults aged ≥60 years. However, estimates of the cost effectiveness of this vaccine vary widely, in part because of gaps in the data on the value of preventing herpes zoster. Our aims were to (i) generate comprehensive information on the value of preventing a range of outcomes of herpes zoster; (ii) compare these values among community members and patients with shingles and post-herpetic neuralgia (PHN); and (iii) identify clinical and demographic characteristics that explain the variation in these values. Community members drawn from a nationally representative survey research panel (n = 527) completed an Internet-based survey using time trade-off and willingness-to-pay questions to value a series of scenarios that described cases of herpes zoster with varying pain intensities (on a scale of 0 to 10, where 0 represents no pain and 10 represents the worst imaginable pain) and duration (30 days to 1 year). Patients with shingles (n = 382) or PHN (n = 137) [defined as having symptoms for =90 days] from two large healthcare systems completed telephone interviews with similar questions to the Internet-based survey and also answered questions about their current experience with herpes zoster. We constructed generalized linear mixed models to evaluate the associations between demographic and clinical characteristics, the length and intensity of the health states and time trade-off and willingness-to-pay values. In time trade-off questions, community members offered a mean of 89 (95% CI 24, 182) discounted days to avoid the least severe scenario (pain level of 3 for 1 month) and a mean of 162 (95% CI 88, 259) discounted days to avoid the most severe scenario (pain level of 8 for 12 months). Compared with patients with shingles, community members traded more days to avoid low-severity scenarios but similar numbers of days to avoid high-severity scenarios. Compared with patients with PHN, community members traded fewer days to avoid high-severity scenarios. In multivariate analyses, older age was the only characteristic significantly associated with higher time trade-off values. In willingness-to-pay questions, community members offered a mean of $US450 (95% CI 203, 893) to avoid pain of level 3 for 1 month and a mean of $US1384 (95% CI 873, 2050) [year 2005 values] to avoid pain of level 8 for 12 months. Community members traded less money than patients with either shingles or PHN to avoid both low- and high-severity scenarios (p-values
Databáze: OpenAIRE