Long-Term Mortality and State Financial Support in Invasive Meningococcal Disease-Real-World Data Analysis Using the French National Claims Database (SNIIRAM)
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Published on: December 6, 2016
Jing Shen1, Stéphane Bouée2, Emmanuel Aris1
1GSK, Value Evidence, Avenue Fleming 20, 1300, Wavre, Belgium.
Objectives:
Invasive meningococcal disease (IMD) is an uncommon disease known for its acute phase mortality and long-term sequelae. The objective was to assess the impact of IMD on post-discharge mortality risk and dependence on the French state for financial aid.
Methods:
A 6-year retrospective analysis in the national insurance database (SNIIRAM) assessed mortality in IMD cases (both during acute phase and post-discharge) and matched controls as well as benefit claims (i.e., for salary loss compensation [SLC], long-term sickness [ALD] and complementary health insurance [CMUc]). Observed survival data were extrapolated to estimate lifetime life expectancy following IMD.
Results:
Between 2012 and 2017, 3532 incident IMD cases were hospitalised in France (peak in < 2 years and 15-24 year olds), of which 23.3% developed sequelae. With an average follow-up of 2.8 years, 12.9% of cases vs. 3.2% of controls died (p < 0.0001), with significantly more cases than controls dying both during the acute phase and post-discharge. Around a third of these deaths occurred post-discharge. Extrapolation to lifetime life expectancy estimated that having IMD at any age significantly reduces life expectancy in survivors of the acute disease phase, e.g., by around 16 years for cases aged 0-50 years. IMD cases in France were significantly more likely to receive state-funded SLC (relative risk [RR] 3.9, 95% confidence interval [95% CI] 2.3-6.4) and ALD benefits (RR 1.85, 95% CI 1.71-2.00).
Conclusions:
IMD has a significant impact on mortality post-discharge, expected to persist over a lifetime. In addition to long-term sequelae, the financial burden extends beyond the healthcare sector. These results highlight the importance of IMD prevention (e.g., vaccination).
Insights
Invasive meningococcal disease (IMD) significantly increases long-term mortality and financial dependence on the state. Survivors face reduced life expectancy and increased need for social benefits, underscoring the importance of prevention.
Area of Science:
- Epidemiology
- Public Health
- Infectious Diseases
Background:
- Invasive meningococcal disease (IMD) is a severe infection with high mortality and potential long-term complications.
- Understanding the long-term impact of IMD on survivors is crucial for public health planning.
Purpose of the Study:
- To evaluate the impact of IMD on post-discharge mortality.
- To assess the long-term financial dependence on state aid among IMD survivors.
Main Methods:
- A 6-year retrospective analysis of the French national insurance database (SNIIRAM).
- Comparison of mortality rates and benefit claims (salary loss, long-term sickness, health insurance) between IMD cases and matched controls.
- Extrapolation of survival data to estimate lifetime life expectancy.
Main Results:
- IMD cases showed significantly higher mortality than controls, both during acute phase and post-discharge (12.9% vs. 3.2%).
- Approximately one-third of IMD-related deaths occurred post-discharge.
- IMD survivors faced a reduced life expectancy (estimated 16 years for ages 0-50) and were more likely to receive state financial aid (SLC and ALD benefits).
Conclusions:
- IMD imposes a significant long-term mortality risk and reduces life expectancy.
- Survivors experience substantial financial burdens, increasing dependence on state social benefits.
- These findings emphasize the critical need for IMD prevention strategies, such as vaccination.
