Patient and economic burdens of postherpetic neuralgia in China
Received 2 February 2019
Accepted for publication 20 June 2019
Published 3 September 2019 Volume 2019:11 Pages 539—550
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 3
Editor who approved publication: Professor Dean Smith
Sheng-Yuan Yu,1 Bi-Fa Fan,2 Fei Yang,1 Marco DiBonaventura,3 Yu-Xuan Chen,4 Ruo-Yu Li,5 Kristen King-Concialdi,6 Ian Kudel,6 Patrick Hlavacek,3 Markay Hopps,3 Margarita Udall,3 Alesia Sadosky,3 Joseph C Cappelleri7
1Department of Neurology, Chinese PLA General Hospital, Beijing, People’s Republic of China; 2Department of Pain Medicine, Pain Management Centre, China-Japan Friendship Hospital, Beijing, People’s Republic of China; 3Pfizer, New York, NY, USA; 4Pfizer China, Beijing, People’s Republic of China; 5Department of Dermatology, Peking University First Hospital, Beijing, People’s Republic of China; 6Kantar Health, New York, NY, USA; 7Pfizer Inc, Groton, CT, USA
Correspondence: Sheng-Yuan Yu
Department of Neurology, Chinese PLA General Hospital, Hai Dian District, Beijing 100853, People’s Republic of China
Tel +86 105 549 9118
Fax +86 108 862 6299
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: postherpetic neuralgia, disease burden, health-related quality-of-life, EQ-5D, China, health care costs, productivity
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