Economic evaluation of antiviral therapy for the treatment of herpes zoster in immunocompetent adults

Shingles (herpes zoster) affects 20% of the population at some stage during their lives. The economic consequences can be significant. For example, in the UK, the costs of post-herpetic neuralgia, a complication that affects between 10 and 14% of patients with shingles, have been estimated between 4.8 million and 17.9 million pounds sterling (Pounds). This study is the first formal assessment of the cost-effectiveness of the 2 most commonly used oral antiviral treatments that have proven efficacy in patients with shingles: famciclovir and aciclovir (acyclovir). It shows that the clinical advantages of famciclovir over aciclovir are accompanied by potential economic advantages in the form of savings in direct costs to the UK National Health Service of between 2.04 pounds and 16.85 pounds per patient treated. Future economic research to validate the benefits of antiviral treatment should focus on prospective assessments alongside controlled trials incorporating resource use analysis, quality-of-life appraisal, assessments of pain severity, and long term follow-up with continuation protocols.