Introduction

Invasive meningococcal disease (IMD) is an uncommon but serious infectious disease. Its economic burden is known to be high but is poorly characterised. The objective of this study was to determine costs, as captured in the healthcare claims database, incurred by all patients hospitalised for IMD in France over a 6-year period.

Methods

This case–control study was performed using the French national public health insurance database (SNDS). Cases comprised all individuals hospitalised with acute IMD in France between 2012 and 2017 inclusive. For each case, three controls were identified, matched for age, gender and region of residence. All healthcare resource consumption by cases and controls during the follow-up period was documented. Costs were analysed for the index hospitalisation in cases, 1 year following the index date and then for 5 years following the index date. Costs were assigned from national tariffs. The analysis was performed from a societal perspective. IMD sequelae were identified from hospital discharge summaries.

Results

A total of 3532 cases and 10,590 controls were evaluated. The mean per capita cost of the index IMD hospitalisation was €11,256, and increased with age and with the presence of sequelae. In the year following the index date, mean per capita direct medical costs were €6564 in cases and €2890 in controls. Annual costs were €4254 in cases without sequelae, €10,799 in cases with one sequela and €20,096 in cases with more than one sequela. In the fifth year of follow-up, mean per capita costs were €2646 in cases and €1478 in controls. The excess cost in cases was principally due to the management of sequelae. Amputation, skin scarring and mental retardation generated per capita costs in excess of €20,000 in the first year and in excess of €10,000 for subsequent years.

Conclusion

The economic burden of IMD in France is high and, over the long-term, is driven by sequelae management.

中文翻译：

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法国侵袭性脑膜炎球菌病的医疗资源消耗和成本：国家健康保险数据库研究

介绍

侵袭性脑膜炎球菌病 (IMD) 是一种罕见但严重的传染病。众所周知，它的经济负担很高，但特征很差。本研究的目的是确定在法国因 IMD 住院的所有患者在 6 年内发生的医疗保健索赔数据库中的费用。

方法

这项病例对照研究是使用法国国家公共健康保险数据库（SNDS）进行的。病例包括 2012 年至 2017 年期间在法国因急性 IMD 住院的所有个体。对于每个病例，确定了三个对照，与年龄、性别和居住地区相匹配。记录了随访期间病例和对照的所有医疗资源消耗。在索引日期之后的 1 年和索引日期之后的 5 年内，分析了索引住院病例的成本。成本由国家关税分配。分析是从社会角度进行的。从出院总结中确定了 IMD 后遗症。

结果

共评估了 3532 例病例和 10,590 例对照。指数 IMD 住院的平均人均费用为 11,256 欧元，并随着年龄和后遗症的存在而增加。在索引日期之后的一年中，病例的平均人均直接医疗费用为 6564 欧元，对照组为 2890 欧元。无后遗症病例的年费用为 4254 欧元，有一种后遗症的病例为 10,799 欧元，有不止一种后遗症的病例为 20,096 欧元。在第五年的随访中，病例的平均人均费用为 2646 欧元，对照组为 1478 欧元。案件的超额费用主要是由于后遗症的管理。截肢、皮肤疤痕和智力迟钝在第一年产生的人均成本超过 20,000 欧元，随后几年超过 10,000 欧元。

结论

法国 IMD 的经济负担很高，从长远来看，是由后遗症管理驱动的。