Cost-effectiveness of acyclovir for varicella infections in immunocompetent patients: A British perspective

We reviewed data on a reportable disease in Tayside, Scotland, from 1988 to 1992 to estimate numbers of patients with chickenpox and the frequency of complications requiring hospitalization in adults. Average cost-effectiveness of acyclovir in dollars per day of symptoms avoided is $70 for children with chickenpox, $170 for adults with chickenpox, and $18 for adults with shingles. If acyclovir treatment is 50% effective at reducing admissions, the implied value is $35,262 per admission avoided, whereas data on prevention of postherpetic neuralgia suggest that treating shingles with acyclovir costs $2125 per case of postherpetic neuralgia avoided. We conclude that acyclovir treatment of patients with shingles is much more cost-effective than unselected acyclovir treatment of adults or children with chickenpox.