Lifetime costs of invasive meningococcal disease: A Markov model approach. Issue 46 (31st October 2019)

• Record Type: Journal Article
• Authors: Wang, Bing; Haji Ali Afzali, Hossein; Giles, Lynne; Marshall, Helen
• Is Part Of: Vaccine. Volume 37:Issue 46(2019)
• Page Start: 6885
• Page End: 6893
• Publication Date: 2019-10-31
• Subjects: Meningococcal disease -- Costs -- Markov model; Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2019.09.060
• Languages: English
• ISSNs: 0264-410X

Abstract

Highlights: A Markov model was constructed to predict lifetime costs of IMD. The burden of IMD is substantial. Significant healthcare costs incurred in young patients and patients with sequelae. Abstract: 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.