Community and patient values for preventing herpes zoster

Area of Science:

• Health Economics
• Preventive Medicine
• Public Health

Background:

• The US Advisory Committee on Immunization Practices recommends a new herpes zoster (shingles) vaccine for adults aged 60+.
• Cost-effectiveness estimates for the shingles vaccine vary due to data gaps on the value of preventing herpes zoster.
• Understanding the value of preventing herpes zoster outcomes is crucial for informed policy decisions.

Purpose of the Study:

• To generate comprehensive data on the value of preventing various herpes zoster outcomes.
• To compare these values between community members and patients with shingles or post-herpetic neuralgia (PHN).
• To identify clinical and demographic factors influencing the valuation of herpes zoster prevention.

Main Methods:

• Nationally representative community members (n=527) completed online surveys using time trade-off and willingness-to-pay questions.
• Patients with shingles (n=382) or PHN (n=137) completed telephone interviews with similar valuation questions.
• Generalized linear mixed models were used to analyze associations between characteristics and valuation responses.

Main Results:

• Community members were willing to trade significant time (mean 89-162 discounted days) and money (mean $450-$1384) to avoid herpes zoster scenarios.
• Patients with shingles or PHN assigned higher monetary values to avoiding herpes zoster compared to community members.
• Older age was associated with higher time trade-off values, while male gender, higher income, and prior experience with shingles/PHN were linked to higher willingness to pay.

Conclusions:

• This study provides comprehensive valuations of preventing herpes zoster from both community and patient perspectives.
• Community members place substantial value on avoiding herpes zoster, even less severe cases.
• Integrating community and patient viewpoints is essential for evaluating the implications of herpes zoster vaccine policies.