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Published on: November 5, 2019
Lifetime costs of invasive meningococcal disease: A Markov model approach
Bing Wang1, Hossein Haji Ali Afzali2, Lynne Giles3
1The University of Adelaide, Adelaide Medical School, Adelaide, South Australia, Australia; The University of Adelaide, The Robinson Research Institute, Adelaide, South Australia, Australia; The University of Adelaide, School of Public Health, Adelaide, South Australia, Australia; Vaccinology and Immunology Research Trials Unit (VIRTU), Women's and Children's Hospital, Adelaide, South Australia, Australia.
Introduction:
Invasive meningococcal disease (IMD) is an uncommon but life-threatening infectious disease associated with high sequelae rates in young children and an increased risk of mortality in adolescents and young adults. Funding decisions to reject inclusion of new meningococcal serogroup B vaccines on national immunisation schedules have been criticised by IMD patients, their families, paediatricians and charity organisations. We aim to estimate the lifetime costs of IMD with the best available evidence to inform cost-effectiveness analyses.
Methods:
A Markov model was developed taking healthcare system and societal perspectives. A range of data including age-specific mortality rates, and probabilities of IMD-related sequelae were derived from a systematic review and meta-analysis. All currencies were inflated to year 2017 prices by using consumer price indexes in local countries and converted to US dollars by applying purchasing power parities conversion rates. Expert panels were used to inform the model development process including key structural choices and model validations.
Results:
The estimated lifetime societal cost is US$319,896.74 per IMD case including the direct healthcare cost of US$65,035.49. Using a discount rate of 5%, the costs are US$54,278.51 and US$13,968.40 respectively. Chronic renal failure and limb amputation result in the highest direct healthcare costs per patient. Patients aged < 5 years incur the higher healthcare expenditure compared with other age groups. The costing results are sensitive to the discount rate, disease incidence, acute admission costs, and sequelae rates and costs of brain injuries and epilepsy.
Conclusions:
IMD can result in substantial costs to the healthcare system and society. Understanding the costs of care can assist decision-making bodies in evaluating cost-effectiveness of new vaccine programs.
Insights
Invasive meningococcal disease (IMD) imposes significant lifetime costs, estimated at over $319,000 per case, impacting both healthcare systems and society. These findings highlight the economic burden and inform vaccine program cost-effectiveness evaluations.
Area of Science:
- Epidemiology
- Health Economics
- Infectious Diseases
Background:
- Invasive meningococcal disease (IMD) presents a severe health threat with high sequelae and mortality rates, particularly in young children and adolescents.
- Rejection of new meningococcal serogroup B vaccines has drawn criticism, necessitating robust economic data for informed funding decisions.
Purpose of the Study:
- To estimate the comprehensive lifetime costs associated with invasive meningococcal disease (IMD).
- To provide crucial data for cost-effectiveness analyses of potential new meningococcal vaccines.
Main Methods:
- A Markov model was developed from both healthcare system and societal perspectives.
- Data on age-specific mortality and IMD-related sequelae were synthesized from systematic reviews and meta-analyses.
- Costs were standardized to 2017 US dollars using consumer price indexes and purchasing power parities.
Main Results:
- The estimated lifetime societal cost per IMD case is $319,896.74, with direct healthcare costs at $65,035.49.
- Chronic renal failure and limb amputation represent the most costly sequelae.
- Young children (<5 years) incur higher healthcare expenditures compared to other age groups.
Conclusions:
- Invasive meningococcal disease (IMD) generates substantial economic burdens on healthcare systems and society.
- Understanding these costs is vital for decision-making bodies evaluating the cost-effectiveness of vaccination programs.
