Healthcare resource use and costs of varicella and its complications: A systematic literature review
Creators: name: Williame, Isabelle
name: George, Marina
name: Shah, Hiral Anil
name: Homer, Natalia
name: Alderson, David
name: Jamet, Nicolas
Publisher: name: Taylor & Francis
Year: 2023
Subjects: subject: Medicine
subject: Sociology
subject: FOS: Sociology
subject: Marine Biology
subject: Cancer
subject: Science Policy

description: Varicella is a highly contagious disease caused by the varicella zoster virus (VZV). While the disease is usually mild, severe complications can occur requiring costly hospitalization. A thorough understanding of the healthcare resource use (HCRU) and costs of varicella is needed to inform health-economic models of preventive strategies. A systematic literature review was carried out to retrieve relevant publications between 1999 and 2021, reporting HCRU and cost outcomes for varicella and its complications. Data were extracted and stratified according to pre-specified age groups and complication categories. Costs were re-based to a $US2020 footing using both purchasing power parity and the medical component of consumer price indexes. Data were summarized descriptively due to high heterogeneity in study design and outcome reporting. Forty-four publications fulfilled the inclusion and exclusion criteria of which 28 were conducted in Europe, 6 in Middle East and Asia, 5 in South America, 3 in North America, and 2 in multiple regions. Primary healthcare visits accounted for 30% to 85% of total direct costs. Hospitalization costs varied between $1,308 and $38,268 per episode depending on country, complication type, and length of stay, contributing between 2% and 60% to total direct costs. Indirect costs, mostly driven by workdays lost, accounted for approximately two-thirds of total costs due to varicella. The management of varicella and related complications can lead to substantial HCRU and costs for patients and the healthcare system. Additional research is needed to further characterize the varicella-associated economic burden and its broader impact from a societal standpoint. Varicella, also known as chickenpox, is a highly contagious infectious disease which affects mostly children. Indeed, &gt;90% of children will have had chickenpox by the age of 12 years. The symptoms are usually mild, but in some cases, serious complications can occur such as pneumonia, bacterial superinfection of the skin and encephalitis. A clear understanding of the complications of chickenpox for patients and the healthcare system would be helpful so that countries can assess the true health and economic burden of the disease. In this study, we have summarized existing published data from around the world. We have included studies that reported on the number of varicella cases, doctor visits, hospitalizations, and costs due to varicella and associated complications. These data showed that varicella causes high costs to the healthcare system. Even though less than 1% of varicella patients need to be hospitalized, costs remain high because varicella is so common. Furthermore, if the number of workdays lost are counted as well, then varicella-related costs are even higher. Varicella and its complications lead to significant primary healthcare resource use because of its high incidence with each episode leading to 1 healthcare visit on average.Varicella-related primary healthcare visits account for 30% to 80% of total direct costs.Varicella-related hospitalizations contribute between 2% and 60% to total direct costs.Varicella-related hospitalizations may occur both in children and adults, with costs ranging between $1,308 and $38,268 per episode depending on severity, complication type and length of stay.Indirect costs are mostly driven by workdays lost and account for approximately two-thirds of total costs. Varicella and its complications lead to significant primary healthcare resource use because of its high incidence with each episode leading to 1 healthcare visit on average. Varicella-related primary healthcare visits account for 30% to 80% of total direct costs. Varicella-related hospitalizations contribute between 2% and 60% to total direct costs. Varicella-related hospitalizations may occur both in children and adults, with costs ranging between $1,308 and $38,268 per episode depending on severity, complication type and length of stay. Indirect costs are mostly driven by workdays lost and account for approximately two-thirds of total costs.