Assessment of Economic Burden of Concurrent Measles and Rubella Outbreaks, Romania, 2011-2012.

Joseph Njau,Sarah S Pallas,Daniel Ciurea,Aurora Stanescu,Aaron S Wallace,Cassandra Butu,Adriana Pistol,Denisa Janta,Nino Khetsuriani,Laura Zimmerman,Susan Reef

doi:10.3201/eid2506.180339

Abstract

We estimated the economic impact of concurrent measles and rubella outbreaks in Romania during 2011–2012. We collected costs from surveys of 428 case-patients and caretakers, government records, and health staff interviews. We then estimated financial and opportunity costs. During the study period, 12,427 measles cases and 24,627 rubella cases were recorded; 27 infants had congenital rubella syndrome (CRS). The cost of the outbreaks was US $9.9 million. Cost per case was US $439 for measles, US $132 for rubella, and US $44,051 for CRS. Up to 36% of households needed to borrow money to pay for illness treatment. Approximately 17% of patients continued to work while ill to pay their treatment expenses. Our key study findings were that households incurred a high economic burden compared with their incomes, the health sector bore most costs, and CRS costs were substantial and relevant to include in rubella outbreak cost studies.

Highlights

We estimated the economic impact of concurrent measles and rubella outbreaks in Romania during 2011–2012
Little information is available on the economic impact of measles and rubella outbreaks in a middle-income country, and in 2011, this impact was identified as a global research priority [6]
We found no notable differences in transportation or overall spending for households residing in rural areas compared with those in urban settings, which might reflect the history of widespread geographic availability of healthcare by state-owned polyclinics throughout Romania

Summary

Introduction

We estimated the economic impact of concurrent measles and rubella outbreaks in Romania during 2011–2012. Cost per case was US $439 for measles, US $132 for rubella, and US $44,051 for CRS. Our key study findings were that households incurred a high economic burden compared with their incomes, the health sector bore most costs, and CRS costs were substantial and relevant to include in rubella outbreak cost studies. Economic impact studies of measles and rubella outbreaks in high-income countries illustrate a high cost of outbreaks and response activities [1,2,3,4,5]. We estimated the economic cost of these outbreaks and response activities incurred by the health sector and households of persons with measles or rubella infection

Methods

Results

Conclusion