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瑞典带状疱疹及带状疱疹后神经痛的负担。

Burden of herpes zoster and post-herpetic neuralgia in Sweden.

作者信息

Nilsson Jonas, Cassel Tobias, Lindquist Lars

机构信息

Mapi Group, Stockholm, Klarabergsviadukten 90D, SE-111 64, Stockholm, Sweden.

Sanofi Pasteur MSD, Solna, Sweden.

出版信息

BMC Infect Dis. 2015 May 22;15:215. doi: 10.1186/s12879-015-0951-7.

Abstract

BACKGROUND

The societal economic burden of herpes zoster in Sweden is not well described today. This study is a top-down analysis of Swedish registers with the objective to describe the burden of herpes zoster and post-herpetic neuralgia in Sweden during 2011.

METHODS

Data for inpatient care; outpatient primary and specialized cares; the prescriptions of drugs, sick leave and the number or diagnostic tests were collected from Swedish national databases. The incidence of the disease was estimated based on the number of prescriptions of antiviral drugs.

RESULTS

The incidence of herpes zoster was estimated to 315 and 577 cases per 100,000 people for patients at all ages and > = 50 years, respectively. Almost 30,000 patients at all ages were diagnosed with herpes zoster and the societal cost to treat these patients, including the cost to treat those patients who later developed post-herpetic neuralgia, added up to nearly 227 MSEK (31.6 M€) which corresponds to 7,600 SEK (€870) per patient. The main contributors to the total cost for the treatment of HZ patients were primary care (43 %); sick leave (28 %); hospitalization (10 %) and specialist care (7 %). Medication was a relatively small contributor with 8.5 MSEK (4 %; 1.0 M€) to the overall costs for patients at all ages. The corresponding total cost including only patients 50 years and older was 168 MSEK (19.2 M€) or 8,200 SEK (€939) per patient.

CONCLUSIONS

The current study demonstrates that the burden of herpes zoster is significant in Sweden. The society, the health care payers and the patients potentially have a lot to gain by introducing a vaccination program to patients 50 years and older and as a consequence reduce the economic and clinical burden of herpes zoster and post-herpetic neuralgia.

摘要

背景

目前瑞典带状疱疹的社会经济负担尚无详尽描述。本研究是一项对瑞典登记数据的自上而下分析,旨在描述2011年瑞典带状疱疹及带状疱疹后神经痛的负担情况。

方法

从瑞典国家数据库收集住院治疗、门诊初级和专科护理、药物处方、病假及诊断检查数量的数据。基于抗病毒药物处方数量估算疾病发病率。

结果

各年龄段和年龄≥50岁患者的带状疱疹发病率分别估计为每10万人315例和577例。各年龄段近30000名患者被诊断为带状疱疹,治疗这些患者的社会成本,包括治疗后来发展为带状疱疹后神经痛患者的成本,总计近2.27亿瑞典克朗(3160万欧元),相当于每位患者7600瑞典克朗(870欧元)。治疗HZ患者总成本的主要构成部分为初级护理(43%);病假(28%);住院治疗(10%)和专科护理(7%)。药物治疗对各年龄段患者总体成本的贡献相对较小,为850万瑞典克朗(4%;100万欧元)。仅包括50岁及以上患者的相应总成本为1.68亿瑞典克朗(1920万欧元),即每位患者8200瑞典克朗(939欧元)。

结论

当前研究表明,带状疱疹在瑞典的负担较重。通过为50岁及以上患者引入疫苗接种计划,进而减轻带状疱疹及带状疱疹后神经痛的经济和临床负担,社会、医疗保健支付方和患者可能会大有收获。

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