Zeevat Florian, Simons Joost J M, Westra Tjalke A, Wilschut Jan C, van Sorge Nina M, Boersma Cornelis, Postma Maarten J
University Medical Center Groningen, Groningen, The Netherlands.
Health-Ecore, Zeist, The Netherlands.
Infect Dis Ther. 2024 Mar;13(3):481-499. doi: 10.1007/s40121-023-00903-0. Epub 2024 Feb 16.
Invasive meningococcal disease (IMD) caused by Neisseria meningitidis is a rapidly progressing, rare disease that often presents as meningitis or sepsis. It mostly affects infants and adolescents, with high fatality rates or long-term sequelae. In the Netherlands, serogroup B (MenB) is most prevalent. We aimed to estimate the economic burden of MenB-related IMD between 2015 and 2019, including direct and indirect medical costs from short- and long-term sequelae, from a societal perspective.
IMD incidence was based on laboratory-based case numbers from the Netherlands Reference Laboratory for Bacterial Meningitis (Amsterdam UMC, Amsterdam, the Netherlands); there were 74 MenB cases on average per year in the study period 2015-2019. Case-fatality rate (3.8%) and percentage of patients discharged with sequelae (46%) were derived from literature. Direct costs included treatment costs of the acute phase, long-term sequelae, and public health response. Indirect costs were calculated using the human capital (HCA) and friction costs (FCA) approaches, in which productivity losses were estimated for patients and parents during the acute and sequelae phases. Costs were discounted by 4% yearly.
Estimated costs due to MenB IMD in an annual cohort were €3,094,199 with FCA and €9,480,764 with HCA. Direct costs amounted to €2,974,996, of which 75.2% were related to sequelae. Indirect costs related to sequelae were €52,532 with FCA and €5,220,398 with HCA.
Our analysis reflects the high economic burden of MenB-related IMD in the Netherlands. Sequelae costs represent a high proportion of the total costs. Societal costs were dependent on the applied approach (FCA or HCA).
由脑膜炎奈瑟菌引起的侵袭性脑膜炎球菌病（IMD）是一种进展迅速的罕见疾病，通常表现为脑膜炎或败血症。它主要影响婴儿和青少年，病死率高或有长期后遗症。在荷兰，B群（MenB）最为常见。我们旨在从社会角度估计2015年至2019年期间与MenB相关的IMD的经济负担，包括短期和长期后遗症的直接和间接医疗费用。
IMD发病率基于荷兰细菌性脑膜炎参考实验室（荷兰阿姆斯特丹大学医学中心，阿姆斯特丹）基于实验室的病例数；在2015 - 2019年研究期间，平均每年有74例MenB病例。病死率（3.8%）和有后遗症出院患者的百分比（46%）来自文献。直接成本包括急性期治疗成本、长期后遗症和公共卫生应对成本。间接成本使用人力资本（HCA）和摩擦成本（FCA）方法计算，其中估计了患者和家长在急性期和后遗症期的生产力损失。成本按每年4%进行贴现。
年度队列中因MenB IMD估计的成本，采用FCA为3,094,199欧元，采用HCA为9,480,764欧元。直接成本总计2,974,996欧元，其中75.2%与后遗症相关。与后遗症相关的间接成本，采用FCA为52,532欧元，采用HCA为5,220,398欧元。
我们的分析反映了荷兰与MenB相关的IMD的高经济负担。后遗症成本占总成本的很大比例。社会成本取决于所采用的方法（FCA或HCA）。
