Cost of illness of invasive meningococcal disease caused by serogroup B Neisseria meningitidis in Spain

Introduction: Invasive meningococcal disease (IMD) is a severe infectious disease, mainly affecting children under 5 years, associated with long-term physical, neurological and psychological sequelae. In Spain, most IMD cases are caused by meningococcal serogroup B (MenB). This study estimates its economic burden from a societal perspective in Spain. Methods: A previously published bottom-up, model-based incidence costing approach by Scholz et al. (2019) to estimate the economic burden of MenB in Germany was adapted to the Spanish setting. Diagnosis and age-related costs for a hypothetical Spanish cohort were calculated over a lifetime horizon. Official Spanish databases, literature and expert opinion were used as data sources. The costs were updated to 2019 prices, and a 3% discount rate was applied. Direct costs related to the acute IMD phase, long-term sequelae, rehabilitation and public health response were considered. Indirect costs included productivity losses and premature mortality and were calculated using the human-capital approach (HCA) and friction-cost approach (FCA). Deterministic and probabilistic sensitivity analyses were also performed. Result: At base-case, the total cost for a cohort of 142 patients (2017-2018 period) was (sic)4.74 million ((sic)33,484/case) using the FCA and 613.14 million ((sic)92,768/case) using the HCA. Direct costs amounted to 64.65 million ((sic)32,765/case). Sequelae costs represented (sic)2.46% of the total cost using the FCA and 77.63% using the HCA. Deterministic sensitivity analysis showed that variation of +/- 20% in the input parameter values (population, epidemiology, productivity, costs) had the greatest influence on the base-case results, and the probabilistic sensitivity analysis showed the probability of fitting base-case estimates was > 99%, both for FCA and HCA. Discussion: MenB IMD is an uncommon but severe disease, with a high economic burden for Spanish society. The elevated costs per IMD case reflect its severity in each patient suffering this disease, especially due to the development of sequelae. (C) 2021 GlaxoSmithKline Biologicals S.A. Published by Elsevier Ltd.