University of Pittsburgh
Herpes zoster is a common problem, particularly in the elderly, that can lead to postherpetic neuralgia - a significant source of suffering and diminished quality of life. Antiviral medications diminish acute and chronic symptoms of zoster, but whether the relatively high cost of these medications is worth their beneficial effects is controversial. This review updates our prior analysis, synthesizing evidence on the clinical features and costs of zoster and its sequellae, as well as the effects of antiviral therapy, using decision analysis techniques. We find antiviral therapy economically reasonable in immunocompetent adults for whom treatment is clinically recommended: severely symptomatic acute zoster in any adult and milder zoster in adults of 50-60 years or older.