title: Costs of surviving meningococcal disease in Spain: evaluation for two cases of severe meningitis and septicaemia.
abstract: OBJECTIVE
  The aim of this study was to count the lifelong rehabilitation costs associated with surviving meningococcal disease with major sequelae from the perspective of the Spanish National Healthcare System (NHS) and the national government.
  
  
  METHODS
  Two severe scenarios describing meningococcal disease were developed, one case that represented meningococcal septicaemia and another case for meningococcal meningitis. The scenarios were developed based on a literature review on severe sequelae of meningococcal disease, and discussions with paediatricians who have been responsible for the treatment of children with this disease in Spain. Second, a detailed list of all health, educational and social care resources used by survivors during their acute illness and during the rest of their lives and by family members was obtained by interviewing survivors and their families. Professionals in health and social care were also interviewed to complete the list of resources and ensure the scenario's were accurate. The costs attributed to these resources were obtained from tariff lists, catalogues and published information by the national authorities. All costs were based on a life expectancy of a survivor of 70 years and expressed in EUR 2012.
  
  
  RESULTS
  In this study it was estimated that the lifelong discounted rehabilitation costs associated with the treatment of long-term sequelae due to meningococcal disease are approximately €1180,000-€1400,000. Medical care and social care were the main cost drivers for both septicaemia and meningitis. Annual costs showed to be the largest in the first year after diagnosis of the disease for both cases, due to high hospital admission and medical care costs during this period and decreased significantly over the years.
  
  
  CONCLUSIONS
  This study shows that the lifelong rehabilitation costs associated with the survival of meningococcal disease with severe sequelae place an important burden on the NHS budget and governmental resources in Spain.
authors.affiliation: University of Barcelona, Barcelona, Spain. Electronic address: darba@ub.edu.
authors.forename: Josep
authors.initials: J
authors.lastname: Darbà
authors.affiliation: BCN Health Economics & Outcomes Research SL, Barcelona, Spain.
authors.forename: Lisette
authors.initials: L
authors.lastname: Kaskens
authors.affiliation: Novartis, Basel, Switzerland.
authors.forename: Mareile
authors.initials: M
authors.lastname: Hark
authors.affiliation: Meningitis Research Foundation, Bristol, UK.
authors.forename: Claire
authors.initials: C
authors.lastname: Wright
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007223:Infant; D008297:Male; D008585:Meningitis, Meningococcal / Q000191:economics / Q000209:etiology; D008589:Meningococcal Infections / Q000150:complications / Q000191:economics* / Q000534:rehabilitation; D008875:Middle Aged; D012046:Rehabilitation / Q000191:economics*; D018805:Sepsis / Q000191:economics / Q000209:etiology; D013030:Spain; D013222:State Medicine; D055815:Young Adult
keywords: Lifelong rehabilitation costs; Major sequelae; Meningitis; Meningococcal disease; Resources; Sepsis