Costs of Sequelae Associated with Invasive Meningococcal Disease: Findings from a US Managed Care Population

Abstract

Objectives To assess health care utilization and costs among patients experiencing invasive meningococcal disease (IMD)-related sequelae compared with IMD patients without sequelae. Study Design A retrospective cohort analysis of an administrative claims database for years 1997-2009. Patients with IMD-related inpatient admissions and continuous health plan enrollment were selected and categorized by the presence (complicated IMD) or absence (uncomplicated IMD) of IMD-related sequelae during the 12-month follow-up period. Univariate and multivariable analyses assessed differences in health care utilization and related costs between the 2 patient groups. Results We identified 343 patients; 117 (34%) had a diagnosis claim for at least one IMD-related sequela during the follow-up period. Multivariable analyses showed significantly higher total health care costs for complicated IMD cases (mean: $96,826; 95% confidence interval: $88,659-$104,993) compared with uncomplicated IMD cases (mean: $32,414; 95% confidence interval: $30,825-$34,003). Risk of rehospitalization after initial IMD admission was higher for patients with complicated IMD (hazard ratio = 1.7; 95% confidence interval: 1.0-2.7; P = .034) compared with patients with uncomplicated IMD. Conclusion(s) Predicted health care costs among patients with complicated IMD were 3 times higher compared with patients with uncomplicated IMD. These costs should be considered when economic evaluations of meningococcal vaccination programs are made.