Health Outcomes, Healthcare Resource Use, and Economic Burden of Invasive Meningococcal Disease in the United States Among Children Aged <11 Years

Although uncommon, invasive meningococcal disease (IMD) is a serious and life-threatening illness. In the United States (US), incidence is highest among infants aged <1 year, but research characterizing pediatric IMD burden is limited. This study aimed to evaluate health outcomes and economic burden (healthcare resource utilization [HCRU] and costs [associated with health outcomes and HCRU]) in US individuals aged <11 years with IMD and without IMD, and their caregivers, from the patient and payer (commercial and Medicaid insurance) perspective. Retrospective claims analysis utilizing real-world data (1/1/2005–12/31/2022) from the MarketScan® Commercial and Multi-State Medicaid Databases compared health outcomes, HCRU (e.g., inpatient and outpatient admissions, surgical procedures, pharmacy claims), and costs (associated with health outcomes and HCRU) in commercially and Medicaid-insured infants (aged <1 year), toddlers (aged 1–4 years), and children (aged 5–10 years) with IMD versus those without IMD (matched 1:5), and their caregivers. Length of follow-up was variable, divided into acute/post-acute phases for individuals with IMD. Infants, toddlers, and children with IMD versus without IMD generally experienced more negative health outcomes and HCRU, and higher associated costs. Common health outcomes among infants with IMD included neurological, physical, and neurodevelopmental/mental health disorders. In the commercially insured cohort, infants with IMD had more inpatient admissions, specialist office visits, and surgical procedures than those without IMD. In the Medicaid-insured cohort, HCRU was higher for infants with IMD versus without IMD. Costs associated with health outcomes and HCRU were higher for infants with IMD versus those without IMD, regardless of insurance cohort. Health outcomes, HCRU, and HCRU-associated costs did not differ for caregivers to individuals with IMD versus without IMD. In this retrospective claims analysis from a dual US patient and payer perspective, infants, toddlers, and children with IMD experienced substantial negative health outcomes and economic burden, regardless of insurance status. Preventive interventions in childhood may lessen the impact of IMD on individuals, families, and healthcare systems. Invasive meningococcal disease (IMD), though uncommon, is a serious and life-threatening illness. In the United States (US), IMD is most common in infants. Using medical insurance information, this study assessed health conditions, healthcare services, and costs reported in US infants (aged <1 year), toddlers (aged 1–4 years), and children (aged 5–10 years) with IMD and their caregivers, compared with similar individuals who did not have IMD. Infants, toddlers, and children were grouped by insurance plan (commercial or Medicaid). Costs were evaluated from the patient and medical insurance perspective. Because IMD is particularly common in infants, we focused mostly on findings in the infant age group, although results were similar for toddlers and children. Neurological disorders were the most common health condition observed in infants with IMD from both the commercially insured and Medicaid-insured groups. Additionally, infants with IMD who had Medicaid insurance used all healthcare services more than Medicaid-insured infants without IMD. Infants with IMD who had commercial insurance had more inpatient admissions, specialist office visits, and surgical procedures than commercially insured infants without IMD. Medical costs for the commercially and Medicaid-insured infants with IMD were greater than the medical costs for infants without IMD, though infants with commercial insurance paid more than infants with Medicaid insurance. No differences were found between caregivers to individuals with IMD and without IMD. Early preventive measures such as vaccination during childhood may reduce the negative consequences of IMD, such as long-lasting health conditions and financial responsibilities, on individuals, families, and healthcare systems.