Advertisement

PharmacoEconomics

, Volume 36, Issue 10, pp 1201–1222 | Cite as

Costs of Invasive Meningococcal Disease: A Global Systematic Review

  • Bing WangEmail author
  • Renee Santoreneos
  • Hossein Afzali
  • Lynne Giles
  • Helen Marshall
Systematic Review

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.

Notes

Acknowledgements

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

Author 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.

Compliance with Ethical Standards

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.

Funding

No funding was received for the preparation of this article.

Supplementary material

40273_2018_679_MOESM1_ESM.docx (19 kb)
Supplementary material 1 (DOCX 18 kb)
40273_2018_679_MOESM2_ESM.docx (20 kb)
Supplementary material 2 (DOCX 19 kb)

References

  1. 1.
    Bettinger JA, Scheifele DW, Le Saux N, Halperin SA, Vaudry W, Tsang R, et al. The disease burden of invasive meningococcal serogroup B disease in Canada. Pediatr Infect Dis J. 2013;32(1):e20–5.Google Scholar
  2. 2.
    Viner RM, Booy R, Johnson H, Edmunds WJ, Hudson L, Bedford H, et al. Outcomes of invasive meningococcal serogroup B disease in children and adolescents (MOSAIC): a case-control study. Lancet Neurol. 2012;11(9):774–83.Google Scholar
  3. 3.
    Edge C, Waight P, Ribeiro S, Borrow R, Ramsay M, Ladhani SN. Clinical diagnoses and outcomes of 4,619 hospitalised cases of laboratory-confirmed invasive meningococcal disease in England: linkage analysis of multiple national databases. J Infect. 2016;73(5):427–36.Google Scholar
  4. 4.
    Nadel S. Prospects for eradication of meningococcal disease. Arch Dis Child. 2012;97(11):993–8.PubMedCentralGoogle Scholar
  5. 5.
    Wang B, Clarke M, Thomas N, Howell S, Afzali HH, Marshall H. The clinical burden and predictors of sequelae following invasive meningococcal disease in Australian children. Pediatr Infect Dis J. 2014;33(3):316–8.Google Scholar
  6. 6.
    Harrison LH, Trotter CL, Ramsay ME. Global epidemiology of meningococcal disease. Vaccine. 2009;24(27 Suppl. 2):B51–63.Google Scholar
  7. 7.
    Department of Health Australian Government. Invasive meningococcal disease: national surveillance report, with a focus on MenW, December 2016 [updated 13 Oct 2017]. https://acpc.gov.au/internet/main/publishing.nsf/Content/5FEABC4B495BDEC1CA25807D001327FA/$File/IMD-Surveillance-report20161212.pdf. Accessed 31 May 2018.
  8. 8.
    Lahra MM, Enriquez RP. Australian meningococcal surveillance programme annual report, 2015. Commun Dis Intell Q Rep. 2016;40(4):E503–11.Google Scholar
  9. 9.
    European Centre for Disease Prevention and Control. Annual epidemiological report 2016: invasive meningococcal disease (2014 data). Stockholm: ECDC; 2016. https://ecdc.europa.eu/en/publications-data/invasive-meningococcal-disease-annual-epidemiological-report-2016-2014-data. Accessed 25 Jul 2017.
  10. 10.
    National Center for Immunization and Respiratory Diseases. Enhanced meningococcal disease surveillance report, 2015 [updated 9 June 2017]. https://www.cdc.gov/meningococcal/downloads/NCIRD-EMS-Report.pdf. Accessed 25 Jul 2017.
  11. 11.
    Pharmaceutical Benefits Advisory Committee. Multicomponent meningococcal group B vaccine, 0.5 mL, injection, prefilled syringe, Bexsero®: July 2015. Pharmaceutical Benefits Scheme; 2014. http://www.pbs.gov.au/pbs/industry/listing/elements/pbac-meetings/psd/2015-07/mulit-component-meningococcal-group-b-vaccine-psd-july-2015. Accessed 25 Jul 2017.
  12. 12.
    Pharmaceutical Benefits Advisory Committee. Multicomponent meningococcal group B vaccine, 0.5 mL, injection, prefilled syringe, Bexsero®: July 2014. Pharmaceutical Benefits Scheme; 2014. http://www.pbs.gov.au/pbs/industry/listing/elements/pbac-meetings/psd/2014-07/meningococcal-vaccine-psd-07-2014. Accessed 25 Jul 2017.
  13. 13.
    Pharmaceutical Benefits Advisory Committee. Multicomponent meningococcal group B vaccine, 0.5 mL, injection, prefilled syringe, Bexsero®: November 2013. Pharmaceutical Benefits Scheme; 2013. http://www.pbs.gov.au/info/industry/listing/elements/pbac-meetings/psd/2013-11/meningococcal-vaccine. Accessed 25 Jul 2017.
  14. 14.
    Joint Committee on Vaccination and Immunisation (JCVI). JCVI interim position statement on use of Bexsero® meningococcal B vaccine in the UK 2013 [updated July 2013]. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/224896/JCVI_interim_statement_on_meningococcal_B_vaccination_for_web.pdf. Accessed 25 Jul 2017.
  15. 15.
    Joint Committee on Vaccination and Immunisation (JCVI). JCVI position statement on use of Bexsero® meningococcal B vaccine in the UK 2014 [updated 21 March 2014]. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/252859/JCVI_MenB_Update.pdf. Accessed 5 Sep 2017.
  16. 16.
    Christensen H, Trotter CL, Hickman M, Edmunds WJ. Re-evaluating cost effectiveness of universal meningitis vaccination (Bexsero) in England: modelling study. BMJ. 2014;349:g5725.PubMedCentralGoogle Scholar
  17. 17.
    Tu HA, Deeks SL, Morris SK, Strifler L, Crowcroft N, Jamieson FB, et al. Economic evaluation of meningococcal serogroup B childhood vaccination in Ontario, Canada. Vaccine. 2014;32(42):5436–46.Google Scholar
  18. 18.
    Larg A, Moss JR. Cost-of-illness studies: a guide to critical evaluation. Pharmacoeconomics. 2011;29(8):653–71.Google Scholar
  19. 19.
    Anonychuk A, Woo G, Vyse A, Demarteau N, Tricco AC. The cost and public health burden of invasive meningococcal disease outbreaks: a systematic review. Pharmacoeconomics. 2013;31(7):563–76.PubMedCentralGoogle Scholar
  20. 20.
    Martinon-Torres F. Deciphering the burden of meningococcal disease: conventional and under-recognized elements. J Adolesc Health. 2016;59(2 Suppl.):S12–20.Google Scholar
  21. 21.
    Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009;21(339):b2700.Google Scholar
  22. 22.
    Drummond MF, Sculpher MJ, Claxton K, Stoddart GL, Torrance GW. Methods for the economic evaluation of health care programmes. Oxford: Oxford University Press; 2015.Google Scholar
  23. 23.
    Motheral B, Brooks J, Clark MA, Crown WH, Davey P, Hutchins D, et al. A checklist for retrospective database studies: report of the ISPOR Task Force on Retrospective Databases. Value Health. 2003;6(2):90–7.Google Scholar
  24. 24.
    Kleine-Budde K, Touil E, Moock J, Bramesfeld A, Kawohl W, Rossler W. Cost of illness for bipolar disorder: a systematic review of the economic burden. Bipolar Disord. 2014;16(4):337–53.Google Scholar
  25. 25.
    Ernstsson O, Gyllensten H, Alexanderson K, Tinghog P, Friberg E, Norlund A. Cost of illness of multiple sclerosis: a systematic review. PLoS One. 2016;11(7):e0159129.PubMedCentralGoogle Scholar
  26. 26.
    Kim DD, Basu A. Estimating the medical care costs of obesity in the United States: systematic review, meta-analysis, and empirical analysis. Value Health. 2016;19(5):602–13.Google Scholar
  27. 27.
    Jarbrink K, Ni G, Sonnergren H, Schmidtchen A, Pang C, Bajpai R, et al. The humanistic and economic burden of chronic wounds: a protocol for a systematic review. Syst Rev. 2017;6(1):15.PubMedCentralGoogle Scholar
  28. 28.
    Budhia S, Mikyas Y, Tang M, Badamgarav E. Osteoporotic fractures: a systematic review of U.S. healthcare costs and resource utilization. Pharmacoeconomics. 2012;30(2):147–70.Google Scholar
  29. 29.
    Seuring T, Archangelidi O, Suhrcke M. The economic costs of type 2 diabetes: a global systematic review. Pharmacoeconomics. 2015;33(8):811–31.PubMedCentralGoogle Scholar
  30. 30.
    Wodchis WP, Bhatia RS, Leblanc K, Meshkat N, Morra D. A review of the cost of atrial fibrillation. Value Health. 2012;15(2):240–8.Google Scholar
  31. 31.
    Bahia L, Toscano CM, Takemoto ML, Araujo DV. Systematic review of pneumococcal disease costs and productivity loss studies in Latin America and the Caribbean. Vaccine. 2013;2(31 Suppl. 3):C33–44.Google Scholar
  32. 32.
    Shemilt I, Thomas J, Morciano M. A web-based tool for adjusting costs to a specific target currency and price year. Evid Policy. 2010;6(1):51–9.Google Scholar
  33. 33.
    OANDA. Historical exchange rates 2018 [cited 23 April 2018]. https://www.oanda.com/fx-for-business/historical-rates. Accessed 31 May 2018.
  34. 34.
    Kontopantelis E, Reeves D. metaan: random-effects meta-analysis. Stata J. 2010;10(3):395.Google Scholar
  35. 35.
    StataCorp. Stata statistical software: release 14. College Station: StataCorp LP; 2015.Google Scholar
  36. 36.
    Clarke C, Mallonee S. State-based surveillance to determine trends in meningococcal disease. Public Health Rep. 2009;124(2):280–7.PubMedCentralGoogle Scholar
  37. 37.
    Constenla D, Carvalho A, Alvis Guzman N. Economic impact of meningococcal outbreaks in Brazil and Colombia. Open Forum Infect Dis. 2015;2(4):ofv167.PubMedCentralGoogle Scholar
  38. 38.
    Davis KL, Bell TJ, Miller JM, Misurski DA, Bapat B. Hospital costs, length of stay and mortality associated with childhood, adolescent and young adult meningococcal disease in the US. Appl Health Econ Health Policy. 2011;9(3):197–207.Google Scholar
  39. 39.
    Davis KL, Misurski D, Miller J, Karve S. Cost impact of complications in meningococcal disease: evidence from a United States managed care population. Hum Vaccin. 2011;7(4):458–65.Google Scholar
  40. 40.
    Davis KL, Misurski D, Miller JM, Bell TJ, Bapat B. Cost of acute hospitalization and post-discharge follow-up care for meningococcal disease in the US. Hum Vaccin. 2011;7(1):96–101.Google Scholar
  41. 41.
    Gil-Prieto R, Garcia-Garcia L, Alvaro-Meca A, Gonzalez-Escalada A, Viguera Ester P, Gil De Miguel A. The burden of hospitalizations for meningococcal infection in Spain (1997–2008). Vaccine. 2011;29(34):5765–70.Google Scholar
  42. 42.
    Hanquet GC, Agnew E, Trotter CL, Robays J, Dubois, Devriese S, et al. A quadrivalent vaccine against serogroup B meningococcal disease: a cost-effectiveness study. Health technology assessment (HTA). 2014; KCE reports 231.Google Scholar
  43. 43.
    Karve S, Misurski D, Miller J, Davis KL. Costs of sequelae associated with invasive meningococcal disease: findings from a US managed care population. Health Outcomes Res Med. 2011;2(4):e215–26.Google Scholar
  44. 44.
    Letouze D, Yao G, Clarke SC. The costs associated with the public health management of a cluster of meningococcal infection in England. Vaccine. 2014;32(43):5549–51.Google Scholar
  45. 45.
    Montero JM, Prieto RG, Alejandre CG, Meca LA, Portugal P, de Miguel AG. Hospital admissions for meningococcal infection in Spain (1997–2005). J Infect. 2009;58(1):15–20.Google Scholar
  46. 46.
    O’Brien JA, Caro JJ, Getsios D. Managing meningococcal disease in the United States: hospital case characteristics and costs by age. Value Health. 2006;9(4):236–43.Google Scholar
  47. 47.
    Pinzon-Redondo H, Coronell-Rodriguez W, Diaz-Martinez I, Guzman-Corena A, Constenla D, Alvis-Guzman N. Estimating costs associated with a community outbreak of meningococcal disease in a colombian Caribbean city. J Health Popul Nutr. 2014;32(3):539–48.PubMedCentralGoogle Scholar
  48. 48.
    Tirani M, Meregaglia M, Melegaro A. Health and economic outcomes of introducing the new MenB vaccine (Bexsero) into the Italian routine infant immunisation programme. PLoS One. 2015;10(4):e0123383.PubMedCentralGoogle Scholar
  49. 49.
    Wang B, Haji Ali Afzali H, Marshall H. The inpatient costs and hospital service use associated with invasive meningococcal disease in South Australian children. Vaccine. 2014;32(37):4791–8.Google Scholar
  50. 50.
    Benard S, Wright C, Voisine J, Olivier CW, Gaudelus J. Lifetime cost of meningococcal disease in France: scenarios of severe meningitis and septicemia with purpura fulminans. J Infect Public Health. 2016;9(3):339–47.Google Scholar
  51. 51.
    Darba J, Kaskens L, Hark M, Wright C. Costs of surviving meningococcal disease in Spain: evaluation for two cases of severe meningitis and septicaemia. Vaccine. 2014;32(39):5006–12.Google Scholar
  52. 52.
    Wright C, Wordsworth R, Glennie L. Counting the cost of meningococcal disease: scenarios of severe meningitis and septicemia. Paediatr Drugs. 2013;15(1):49–58.Google Scholar
  53. 53.
    Kennedy ITR, van Hoek AJ, Ribeiro S, Christensen H, Edmunds WJ, Ramsay ME, et al. Short-term changes in the health state of children with group B meningococcal disease: a prospective, national cohort study. PLoS One. 2017;12(5):e0177082.PubMedCentralGoogle Scholar
  54. 54.
    Vyse A, Anonychuk A, Jakel A, Wieffer H, Nadel S. The burden and impact of severe and long-term sequelae of meningococcal disease. Expert Rev Anti Infect Ther. 2013;11(6):597–604.Google Scholar
  55. 55.
    Pelton SI. The global evolution of meningococcal epidemiology following the introduction of meningococcal vaccines. J Adolesc Health. 2016;59(2 Suppl.):S3–11.Google Scholar
  56. 56.
    Sadarangani M, Scheifele DW, Halperin SA, Vaudry W, Le Saux N, Tsang R, et al. Outcomes of invasive meningococcal disease in adults and children in Canada between 2002 and 2011: a prospective cohort study. Clin Infect Dis. 2015;60(8):e27–35.Google Scholar
  57. 57.
    Christensen H, Irving T, Koch J, Trotter CL, Ultsch B, Weidemann F, et al. Epidemiological impact and cost-effectiveness of universal vaccination with Bexsero® to reduce meningococcal group B disease in Germany. Vaccine. 2016;34(29):3412–9.Google Scholar
  58. 58.
    Gasparini R, Landa P, Amicizia D, Icardi G, Ricciardi W, de Waure C, et al. Vaccinating Italian infants with a new multicomponent vaccine (Bexsero®) against meningococcal B disease: a cost-effectiveness analysis. Hum Vaccin Immunother. 2016;12(8):2148–61.PubMedCentralGoogle Scholar
  59. 59.
    Drummond MF, Sculpher MJ, Claxton K, Stoddart GL, Torrance GW. Methods for the economic evaluation of health care programmes. Oxford: Oxford University Press; 2015. p. 245–50.Google Scholar
  60. 60.
    Hepkema H, Pouwels KB, van der Ende A, Westra TA, Postma MJ. Meningococcal serogroup A, C, W(1)(3)(5) and Y conjugated vaccine: a cost-effectiveness analysis in the Netherlands. PLoS One. 2013;8(5):e65036.PubMedCentralGoogle Scholar
  61. 61.
    Erickson L, De Wals P. Complications and sequelae of meningococcal disease in Quebec, Canada, 1990–1994. Rev Infect Dis. 1998;26(5):1159–64.Google Scholar
  62. 62.
    Lecocq H, Parent du Chatelet I, Taha MK, Levy-Bruhl D, Dervaux B. Epidemiological impact and cost-effectiveness of introducing vaccination against serogroup B meningococcal disease in France. Vaccine. 2016;34(19):2240–50.Google Scholar
  63. 63.
    Balmer P, Burman C, Serra L, York LJ. Impact of meningococcal vaccination on carriage and disease transmission: a review of the literature. Hum Vaccin Immunother. 2018.  https://doi.org/10.1080/21645515.2018.1454570 (Epub ahead of print).PubMedCentralGoogle Scholar
  64. 64.
    Breakwell L, Whaley M, Khan UI, Bandy U, Alexander-Scott N, Dupont L, et al. Meningococcal carriage among a university student population: United States, 2015. Vaccine. 2018;36(1):29–35.Google Scholar
  65. 65.
    McNamara LA, Thomas JD, MacNeil J, Chang HY, Day M, Fisher E, et al. Meningococcal carriage following a vaccination campaign with MenB-4C and MenB-FHbp in response to a university serogroup B meningococcal disease outbreak: Oregon, 2015–2016. J Infect Dis. 2017;216(9):1130–40.PubMedCentralGoogle Scholar
  66. 66.
    Shaker R, Fayad D, Dbaibo G. Challenges and opportunities for meningococcal vaccination in the developing world. Hum Vaccin Immunother. 2018.  https://doi.org/10.1080/21645515.2018.1434463 (Epub ahead of print).PubMedCentralGoogle Scholar
  67. 67.
    Australian Technical Advisory Group on Immunisation. The Australian immunisation handbook. 10th ed. Canberra: Australian Government Department of Health; 2015 (2015 update).Google Scholar
  68. 68.
    Borrow R, Alarcon P, Carlos J, Caugant DA, Christensen H, Debbag R, et al. The Global Meningococcal Initiative: global epidemiology, the impact of vaccines on meningococcal disease and the importance of herd protection. Expert Rev Vaccines. 2017;16(4):313–28.Google Scholar
  69. 69.
    Timmis JK, Black S, Rappuoli R. Improving accountability in vaccine decision-making. Expert Rev Vaccines. 2017;16(11):1057–66.Google Scholar
  70. 70.
    Committee Pharmaceutical Benefits Advisory. Guidelines for preparing submissions to the Pharmaceutical Benefits Advisory Committee (version 5.0). Canberra: Australian Government Department of Health and Ageing; 2016.Google Scholar
  71. 71.
    Erickson LJ, De Wals P, Farand L. An analytical framework for immunization programs in Canada. Vaccine. 2005;23(19):2470–6.Google Scholar
  72. 72.
    Carter D, Vogan A, Haji Ali Afzali H. Governments need better guidance to maximise value for money: the case of Australia’s Pharmaceutical Benefits Advisory Committee. Appl Health Econ Health Policy. 2016;14(4):401–7.Google Scholar
  73. 73.
    Mihaylova B, Briggs A, O’Hagan A, Thompson SG. Review of statistical methods for analysing healthcare resources and costs. Health Econ. 2011;20(8):897–916.Google Scholar
  74. 74.
    Desmedt M, Vertriest S, Hellings J, Bergs J, Dessers E, Vankrunkelsven P, et al. Economic impact of integrated care models for patients with chronic diseases: a systematic review. Value Health. 2016;19(6):892–902.Google Scholar
  75. 75.
    Jo C. Cost-of-illness studies: concepts, scopes, and methods. Clin Mol Hepatol. 2014;20(4):327–37.PubMedCentralGoogle Scholar
  76. 76.
    Jacobs P, Ohinmaa A, Brady B. Providing systematic guidance in pharmacoeconomic guidelines for analysing costs. Pharmacoeconomics. 2005;23(2):143–53.Google Scholar
  77. 77.
    Onukwugha E, McRae J, Kravetz A, Varga S, Khairnar R, Mullins CD. Cost-of-illness studies: an updated review of current methods. Pharmacoeconomics. 2016;34(1):43–58.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Adelaide Medical SchoolThe University of AdelaideAdelaideAustralia
  2. 2.Robinson Research InstituteThe University of AdelaideAdelaideAustralia
  3. 3.School of Public HealthThe University of AdelaideAdelaideAustralia
  4. 4.Vaccinology and Immunology Research Trials UnitWomen’s and Children’s HospitalNorth AdelaideAustralia
  5. 5.Royal Adelaide HospitalAdelaideAustralia

Personalised recommendations