Assessing the economic burden of pertussis

Real world study to assist market access activities for a vaccine product

The challenge

The UK suffered a pertussis epidemic in 2012, a condition which is associated with high costs driven by hospitalisation of infants with severe symptoms. Our client wanted to understand the economic burden of pertussis on the English secondary care system and compare it to previous years and to that of five other infectious diseases.

Topics of interest included the number of patients, total cost and per patient cost on an annual basis. They were also interested in further analyses related specifically to pertussis including Healthcare Resource Group (HRG) code, mean length of stay, admission type, IMD score and presence of low birth weight. To our knowledge, this was the first quantification of the economic burden of the 2012 pertussis outbreak.

The solution

A team from across our Adelphi Real World, Value & Outcomes Powerhouse worked to access and analyse hospital episode statistics (HES) data from 2006 to 2013 in annual time bands (1st March – 28th/29th February). HRG codes and associated cost tariffs were used to calculate the cost burden to the secondary care system in England compared to demographically-matched controls for all diseases (Figure 1). Additional pertussis-specific analyses were conducted relating to the other variables of interest.

Key results

Key data identified from our research confirmed that:

• The annual cost burden of the 2012/13 pertussis outbreak was £2,201,773, which was greater than double that of the previous peak year in 2008/09. This was driven by a two fold increase in patient numbers as the average cost burden per patient remained fairly consistent across the years.
• Pertussis admissions lasted for 5 days on average and the vast majority were emergency admissions for infants under one year of age.
• A higher percentage of pertussis than control patients were underweight at birth, whereas no meaningful difference was found in IMD score.

Value to the client

The insight from this project gave our client a better idea of the secondary care costs associated with each of the six infectious diseases. The results of the study were used to communicate the importance of maintaining high vaccination rates by highlighting the cost of disease outbreaks.

The real world evidence was also used to support local market access activities in the UK.  Furthermore, the results of the analysis were covered in the UK press (Figure 2).