OBJECTIVES

Invasive meningococcal disease (IMD) is a rapidly progressive, unpredictable, rare disease that can lead to meningitis and sepsis. IMD is caused by Neisseria meningitidis, affecting mostly infant and adolescent cohorts, where high case fatalities and serious long-term sequelae are prevalent. The prevalent type in Europe and the Netherlands is serotype B. Previously published cost-effectiveness models of IMD prevention often do not include all costs related to the sequelae and therefore strongly underestimate the economic burden. This analysis aims to estimate the economic burden of IMD (due to MenB) in the Netherlands, considering all IMD-related costs, from third-party payer as well as societal perspectives considering the short- and long-term direct and indirect costs and costs related to sequelae.

METHODS

IMD incidence data were requested from the Netherlands Reference Laboratory for Bacterial Meningitis (NRLBM). Direct costs include treatment costs of the acute phase of IMD, long-term sequelae, and costs for public health response. Indirect costs were calculated by applying the human-capital (HCA) and friction costs (FCA) approach in which productivity losses were estimated for patients and parents, during both phases. Data sources include peer-reviewed literature and expert opinion. All costs were discounted (yearly) by 4%.

RESULTS

The model revealed a total of 75 cases of IMD caused by MenB each year, with an overall case fatality of 4% and 47.8% of survivors developing long-term sequelae. This translates into total annual costs of €2,870,022 (€38,512/MenB case) from a third-party-payer-perspective and €2,985,557 (€40,076/MenB case) or €9,214,357 (€123,646/MenB case) from a societal perspective, using FCA or HCA respectively. Of the total direct costs, €2,148,246 (75%) can be attributed to the sequelae.

CONCLUSIONS

MenB is an uncommon but very severe disease. Our analysis reflects the high economic burden of MenB disease in the Netherlands. The total societal costs are strongly dependent on the approach applied.