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Costs of Invasive Meningococcal Disease: A Global Systematic Review

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Abstract

Background

Invasive meningococcal disease remains a public health concern because of its rapid onset and significant risk of death and long-term disability. New meningococcal serogroup B and combination serogroup ACWY vaccines are being considered for publicly funded immunization programs in many countries. Contemporary costing data associated with invasive meningococcal disease are required to inform cost-effectiveness analyses.

Objective

The objective of this study was to estimate costs and resource utilization associated with acute infection and the long-term care of invasive meningococcal disease.

Data Sources and Methods

PubMed, EMBASE, The Cochrane Library, health economic databases, and electronically available conference abstracts were searched. Studies reporting any costs associated with acute infection and long-term sequelae of invasive meningococcal disease in English were included. All costs were converted into purchasing power parity-adjusted estimates [international dollars (I$)] using the Campbell and Cochrane Economics Methods Group and the Evidence for Policy and Practice Information and Coordinating Centre cost converter.

Results

Fourteen studies met our eligibility criteria and were included. The mean costs of acute admission ranged from I$1629 to I$50,796, with an incremental cost of I$16,378. The mean length of hospital stay was reported to be 6–18 days in multiple studies. The average costs reported for readmissions ranged from I$7905 to I$15,908. Key variables such as the presence of sequelae were associated with higher hospitalization costs and longer inpatient stay. No studies estimated direct non-healthcare costs and productivity loss. Ten studies reported only unadjusted mean values without using appropriate statistical methods for adjustment.

Conclusions

Invasive meningococcal disease can result in substantial costs to healthcare systems. However, costing data on long-term follow-up and indirect costs used to populate health economic models are lacking.

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Data Availability Statement

The full dataset including data extracted from the full-text review and quality assessment results that support the findings of this study are available from the corresponding author upon request. The authors declare that all other data supporting the findings of this study are available within the article and its supplementary information files.

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Acknowledgements

Helen Marshall acknowledges support from the National Health and Medical Research Council of Australia: Career Development Fellowship (1084951).

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Authors and Affiliations

  1. Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia

    Bing Wang & Helen Marshall

  2. Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia

    Bing Wang & Helen Marshall

  3. School of Public Health, The University of Adelaide, Adelaide, SA, Australia

    Bing Wang, Hossein Afzali, Lynne Giles & Helen Marshall

  4. Vaccinology and Immunology Research Trials Unit, Women’s and Children’s Hospital, North Adelaide, SA, Australia

    Bing Wang & Helen Marshall

  5. Royal Adelaide Hospital, Adelaide, SA, Australia

    Renee Santoreneos

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Contributions

BW, HM, LG, and HA conceived and designed the study. BW conducted the database searches, extracted, analyzed, and interpreted the data, performed a quality assessment, and produced the draft of the manuscript. RS extracted data and performed a quality assessment. HM, RS, LG, and HA contributed to, reviewed, and edited the manuscript. HM acts as the overall guarantor.

Corresponding author

Correspondence to Bing Wang.

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Conflict of interest

Helen Marshall is an independent investigator on clinical trials of investigational vaccines manufactured by pharmaceutical companies including GlaxoSmithKline, Novavax, and Pfizer. Her institution has received funding for investigator-led research from GlaxoSmithKline, Sanofi-Pasteur, Pfizer, and Novartis Vaccines. Bing Wang, Renee Santoreneos, Hossein Afzali, and Lynne Giles have no conflicts of interest directly relevant to the content of this article.

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Wang, B., Santoreneos, R., Afzali, H. et al. Costs of Invasive Meningococcal Disease: A Global Systematic Review. PharmacoEconomics 36, 1201–1222 (2018). https://doi.org/10.1007/s40273-018-0679-5

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