The economic costs of Group B Streptococcus (GBS) disease: prospective cohort study of infants with GBS disease in England

Abstract

The objective of this study was to estimate the economic costs over the first 2 years of life of Group B Streptococcus (GBS) disease occurring in infants less than 90 days of age. A cost analysis was conducted using a prospective cohort of children born between 2000 and 2003 in the Greater London, Oxford, Portsmouth and Bristol areas of England. Unit costs were applied to estimates of the health and social resource use made by 138 infants diagnosed with GBS disease and 305 non-GBS controls matched for birth weight and hospital stay and time of birth. The health and social care costs for infants exposed to GBS disease were analysed in a multiple linear regression model. The mean health and social care cost over the first 2 years of life was estimated at pound11,968.9 for infants with GBS, compared to pound6,260.7 for the non-GBS controls; a mean cost difference of pound5,708.1 (bootstrap 95% CI pound2,977.1, pound8,391.2, P=0.03). After adjusting for gestational age and other potential confounders in a multiple linear regression, mean societal costs was pound6,144.7 higher among GBS cases than among non-GBS controls (P<0.001). This study shows that the health and social care costs for infants with GBS disease is, on average, two-fold higher during the first 2 years of life than for infants without GBS disease. These data should be used to inform policy decisions regarding the cost-effectiveness of prevention and treatment strategies for GBS disease during early childhood.

Multicenter Clinical Evaluation of the Xpert GBS LB Assay for Detection of Group B Streptococcus in Prenatal Screening Specimens

“…A second study found that PCR screening during pregnancy would be cost neutral and may result in an overall reduction in early-onset GBS disease (32). A small reduction in the incidence of early-onset GBS disease based on the use of a molecular test might also justify the additional cost because, on average, the cost of an early-onset GBS infection is Ͼ€19,000, and infants who survive incur health care and social care costs twice as high as those for unaffected infants (33).…”

Cost‐effectiveness of rapid tests and other existing strategies for screening and management of early‐onset group B streptococcus during labour

“…4,6 In certain conditions it can be transmitted to the baby during labour, colonising the baby and leading to invasive disease. [7][8][9] The risk of developing EOGBS during labour among infants born to colonised mothers is approximately 12 per 1000 births. 10 If affected, the case-fatality rate can be anywhere between 8 and 15%.…”

“…4,10,11 For those infants that survive the disease, the health and social care costs for the first 2 years of life have been estimated to be twice as high as those for unaffected infants. 9 The risk of transmitting GBS to newborns is reduced when intrapartum antibiotic prophylaxis (IAP) is administered to women sufficiently early before the baby is born. 12,13 However, the optimal screening method for identifying and appropriately treating women with GBS is the subject of controversy.…”

Reduction of the use of antimicrobial drugs following the rapid detection ofStreptococcus agalactiaein the vagina at delivery by real‐timePCRassay

“…Even though the incidence of GBS neonatal infection dropped to 0.37 per 1000 births in 2004, the cost of a neonate infection with this bacterium can reach more than €19 000 (National Costs Scale 2007); moreover, for infants that survive the disease, the health and social care costs for the first 2 years of life have been estimated to be twice as high as those for unaffected infants because of possible disabilities. 31 Although these costs should bear upon the total cost, the present study lacked power to estimate the real incidence of infection in neonates. Third, the PCR strategy significantly reduces the number of useless antimicrobial treatments.…”