Medical Expenditure Panel Survey Agency for Healthcare 

Research and Quality

STATISTICAL BRIEF #194 

December 2007 

Average Annual Health Care Use and 

Expenses for Shingles among the

U.S. Civilian Noninstitutionalized 

Population, 2003–2005 

Anita Soni, PhD and Steven C. Hill, PhD 

Introduction 

Shingles is a viral infection caused by the varicella-zoster virus. 

Shingles causes burning or shooting pain, tingling or itching, and 

blisters. This Statistical Brief presents estimates based on the 

Household Component of the Medical Expenditure Panel Survey 

(MEPS-HC) on the use of and expenditures for ambulatory care and 

prescribed medications to treat shingles, pain resulting from 

shingles, and vision complications among the U.S. civilian 

noninstitutionalized population. Average annual estimates (in 2005 

dollars) for the period 2003–2005 are shown by type of service and 

source of payment. Data for three years were combined to improve

the precision of the estimates, and expenditure data for 2003 and 

2004 were adjusted to 2005 dollars using the Personal Health Care 

Expenditure Price Index. All differences between estimates noted in 

the text are statistically significant at the 0.05 level or better. 

Findings 

Number of reported cases, total average health care use, source of 

payment, and expenditures for shingles

In 2003–2005, an annual average of 1.1 million persons had 

shingles or its complications, and 0.9 million sought medical

treatment (figure 1). There was an annual average of 2.1 million ambulatory care visits for the treatment 

of shingles. From 2003–2005, an average of $566 million per year (in 2005 dollars) was spent on health 

care for shingles and its complications (estimate not shown). 

Highlights 

 On average in 2003–2005,

1.1 million persons, per 

year, had shingles or its 

complications; and .9 

million sought medical 

treatment. 

 Medical spending to treat 

shingles or its 

complications totaled on 

average $566 million per 

year for 2003–2005 (in 

2005 dollars).

 For 2003–2005, there was 

an annual average of 2.1 

million ambulatory care 

visits for the treatment of 

shingles or its 

complications.

 The elderly were seven 

times as likely to report 

shingles as the non-elderly 

(1.5 percent of elderly 

versus 0.2 percent of nonelderly). 

 Among those who received

treatment for shingles, 

$525 per person (in 2005 

dollars), on average, was 

spent on treatment. 

Reports of Shingles, by age 

During 2003–2005, an annual average of 0.4 percent of the population reported shingles (figure 2). The 

elderly were more than seven times as likely to report shingles as the non-elderly (1.5 percent of elderly 

versus 0.2 percent of non-elderly). 

Average mean health care expenditures for shingles

Among those who received treatment for shingles, $525 per person (in 2005 dollars), on average, was 

spent on treatment (figure 3). 
Average mean health care expenditures for shingles, by type of service 

Among those with an ambulatory visit related to shingles, $317 per person (in 2005 dollars), on average, 

was spent on shingles-related ambulatory visits (figure 3). An average of $157 was spent per person on 

the prescription medicines for shingles-related treatment among those who obtained prescription 

medications for shingles treatment. 

Distribution of average annual health care expenditures for shingles, by source of payment 

For the treatment of shingles among those age 0–64 during 2003–2005, on average more than half (50.7 

percent) of the expenditures were paid by private insurance, followed by out-of-pocket payments (35.3 

percent) (figure 4). For shingles treatment among those age 65 and older, 40.2 percent of total payments 

were made by Medicare, followed by out-of-pocket payments (29.3 percent).

Data Source 

The estimates shown in this Statistical Brief are based on data from the MEPS 2003, 2004, and 2005 Full 

Year Consolidated Files (HC-079, HC-089, and HC-097), Medical Conditions Files (HC-078, HC-087, and 

HC-096), Office-Based Medical Provider Visit Files (HC-077G, HC-085G, and HC-94G), Outpatient 

Department Visits Files (HC-077F, HC-085F, and HC-094F), Emergency Room Visit Files (HC-077E, HC085E, and HC-094E), and Prescribed Medicine Files (HC-077A, HC-085A, and HC-094A). 

Definitions 

Shingles or its complications 

This brief analyzes individuals with shingles reported as a condition bothering the person and shingles 

reported in connection with reported health care utilization (e.g., a person who reported purchasing a drug 

was asked what condition the drug was intended to treat) or reported disability days. The conditions 

reported by the respondent were recorded by the interviewer as verbatim text, which was then coded by 

professional coders to fully specified ICD-9-CM codes. Conditions with an ICD9 code of 053 were 

classified as shingles or its complications. 

Expenditures 

Payments from all sources for hospital inpatient care, ambulatory care provided in offices and hospital 

outpatient departments, care provided in emergency departments, as well as prescribed medicine 

purchases reported by respondents in the MEPS-HC. Sources include direct payments from individuals, 

private insurance, Medicare, Medicaid, Workers’ Compensation, and miscellaneous other sources. 

Expenditure data for 2003 and 2004 were adjusted to 2005 dollars using the Personal Health Care 

Expenditure Price Index (Centers for Medicare and Medicaid Services, Office of the Actuary). 

About MEPS-HC 

MEPS-HC is a nationally representative longitudinal survey that collects detailed information on health 

care utilization and expenditures, health insurance, and health status, as well as a wide variety of social, 

demographic, and economic characteristics for the civilian noninstitutionalized population. It is 

cosponsored by the Agency for Healthcare Research and Quality and the National Center for Health 

Statistics. 

For more information about MEPS, call the MEPS information coordinator at AHRQ (301-427-1656) or 

visit the MEPS Web site at http://www.meps.ahrq.gov/. 

References 

For a detailed description of the MEPS-HC survey design, sample design and methods used to minimize 

sources of nonsampling errors, see the following publications: 

Cohen, J. Design and Methods of the Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 1. AHCPR Pub. No. 97-0026. Rockville, MD: Agency for Health Care Policy and 

Research, 1997. http://www.meps.ahrq.gov/data_files/publications/mr1/mr1.shtml 
Cohen, S. Sample Design of the 1996 Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 2. AHCPR Pub. No. 97-0027. Rockville, MD: Agency for Health Care Policy and 

Research, 1997. http://www.meps.ahrq.gov/data_files/publications/mr2/mr2.shtml 

Cohen, S. Design Strategies and Innovations in the Medical Expenditure Panel Survey. Medical Care, 

July 2003: 41(7) Supplement: III-5–III-12. 

For more information about shingles, see the following publications: 

National Institute on Aging. Age Page: Shingles. Bethesda, MD: NIA, 2006. 

niapublications.org/agepages/PDFs/Shingles.pdf 

National Institute of Allergy and Infectious Diseases. Shingles. Bethesda, MD: National Library of 

Medicine and the National Institutes of Health, 2007. 

http://www.nlm.nih.gov/medlineplus/shingles.html

Suggested Citation 

Soni, Anita, Hill, Steven C. Average Annual Health Care Use and Expenses for Shingles among the U.S. 

Civilian Noninstitutionalized Population, 2003–2005. Statistical Brief #194. December 2007. Agency for 

Healthcare Research and Quality, Rockville, MD. 

http://www.meps.ahrq.gov/data_files/publications/st194/stat194.pdf 

* * * 

AHRQ welcomes questions and comments from readers of this publication who are interested in 

obtaining more information about access, cost, use, financing, and quality of health care in the United 

States. We also invite you to tell us how you are using this Statistical Brief and other MEPS data and 

tools and to share suggestions on how MEPS products might be enhanced to further meet your needs. 

Please e-mail us at mepspd@ahrq.gov or send a letter to the address below: 

Steven B. Cohen, PhD, Director 

Center for Financing, Access, and Cost Trends 

Agency for Healthcare Research and Quality 

540 Gaither Road 

Rockville, MD 20850 
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey,

2003–2005

0.9

2.1

1.1

0

1

2

3

4

5

Persons with

shingles reports

Persons with

shingles treatment

Ambulatory care

visits

Number in millions

Figure 1. Average annual estimates of reported 

shingles cases, treated cases, and ambulatory

visits for shingles, 2003–2005

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey,

2003–2005

0.2

1.5

0.4

0

1

2

3

4

Total Age 0–64 Age 65+

Percent

Figure 2. Average annual percentage of population 

reporting shingles, by age, 2003–2005

Statistical Brief #194: Average Annual Health Care Use and Expenses for Shingles among the U.S. Civilian 

Noninstitutionalized Population, 2003–2005 
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey,

2003–2005

525

317

157

0

100

200

300

400

500

600

Total Ambulatory care visits Prescription medications

Figure 3. Average annual mean expenditures 

per person with expense, by type of service 

for shingles, 2003–2005

In 2005 d

ollars

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey,

2003–2005

Figure 4. Percentage distribution of average annual

expenditures for shingles, by age and source of payment,

2003–2005

35.3

1.1

50.7

6.5

6.4

29.3

40.2

0.8

8.5

21.2

Private Out-of-pocket Medicare Medicaid Other

Age 0–64 Age 65+

Statistical Brief #194: Average Annual Health Care Use and Expenses for Shingles among the U.S. Civilian 

Noninstitutionalized Population, 2003–2005