Estimated costs and quality-adjusted life-years lost due to N. gonorrhoeae infections acquired in 2015 in the United States: A modelling study of overall burden and disparities by age, race/ethnicity, and other factors
Summary: Background: Disparities in the health and economic burden of gonorrhoea have not been systematically quantified. We estimated population-level health losses and costs associated with gonococcal infection and sequelae in the United States. Methods: We used probability-tree models to capture...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-12-01
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| Series: | The Lancet Regional Health. Americas |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667193X22001818 |
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| author | Yunfei Li Minttu M. Rönn Ashleigh R. Tuite Harrell W. Chesson Thomas L. Gift Thomas A. Trikalinos Christian Testa Meghan Bellerose Katherine Hsu Andrés A. Berruti Yelena Malyuta Nicolas A. Menzies Joshua A. Salomon |
| author_facet | Yunfei Li Minttu M. Rönn Ashleigh R. Tuite Harrell W. Chesson Thomas L. Gift Thomas A. Trikalinos Christian Testa Meghan Bellerose Katherine Hsu Andrés A. Berruti Yelena Malyuta Nicolas A. Menzies Joshua A. Salomon |
| author_sort | Yunfei Li |
| collection | DOAJ |
| description | Summary: Background: Disparities in the health and economic burden of gonorrhoea have not been systematically quantified. We estimated population-level health losses and costs associated with gonococcal infection and sequelae in the United States. Methods: We used probability-tree models to capture gonorrhoea sequelae and to estimate attributable disease burden in terms of the discounted lifetime costs and quality-adjusted life-years (QALYs) lost due to incident infections acquired during 2015 from the healthcare system perspective. Numbers of infections in 2015 were obtained from a published gonorrhoea transmission model. We evaluated population-level disease burden, disaggregated by sex, age, race/ethnicity, and for men who have sex with men (MSM). We conducted a multivariate sensitivity analysis for key parameters. Findings: Discounted lifetime QALYs lost per incident gonococcal infection were estimated as 0.093 (95% uncertainty interval [UI] 0.022-0.22) for women, 0.0020 (0.0015-0.0024) for heterosexual men, and 0.0015 (0.00070-0.0021) for MSM. Discounted lifetime costs per incident infection were USD 261 (109-480), 169 (88-263), and 133 (50-239), respectively. At the population level, total discounted lifetime QALYs lost due to infections acquired during 2015 were 53,293 (12,326-125,366) for women, 621 (430-872) for heterosexual men, and 1,078 (427-1,870) for MSM. Total discounted lifetime costs were USD 150 million (64-277 million), 54 million (25-92 million), and 97 million (34-197 million), respectively. The highest total burden of both QALYs and costs at the population-level was observed in Non-Hispanic Black women, and highest burden per 1,000 person-years was identified in MSM among men and American Indian/Alaska Native among women. Interpretation: Gonorrhoea causes substantial health losses and costs in the United States. These results can inform planning and prioritization of prevention services. Funding: Centers for Disease Control and Prevention, Charles A. King Trust. |
| first_indexed | 2024-04-11T21:26:22Z |
| format | Article |
| id | doaj.art-036d524dfc2a4b80add2b1b001bdc8e0 |
| institution | Directory Open Access Journal |
| issn | 2667-193X |
| language | English |
| last_indexed | 2024-04-11T21:26:22Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Regional Health. Americas |
| spelling | doaj.art-036d524dfc2a4b80add2b1b001bdc8e02022-12-22T04:02:23ZengElsevierThe Lancet Regional Health. Americas2667-193X2022-12-0116100364Estimated costs and quality-adjusted life-years lost due to N. gonorrhoeae infections acquired in 2015 in the United States: A modelling study of overall burden and disparities by age, race/ethnicity, and other factorsYunfei Li0Minttu M. Rönn1Ashleigh R. Tuite2Harrell W. Chesson3Thomas L. Gift4Thomas A. Trikalinos5Christian Testa6Meghan Bellerose7Katherine Hsu8Andrés A. Berruti9Yelena Malyuta10Nicolas A. Menzies11Joshua A. Salomon12Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Corresponding author at: Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 655 Huntington Ave, Boston, MA 02115, USA.Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USADepartment of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USADivision of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USADivision of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USADepartments of Health Services, Policy, & Practice, and of Biostatistics, Brown University, Providence, RI, USADepartment of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USADepartment of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USADivision of STD Prevention & HIV/AIDS Surveillance, Massachusetts Department of Public Health, Boston, MA, USADivision of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USADepartment of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USADepartment of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USACenter for Health Policy / Center for Primary Care and Outcomes Research, Stanford University, Stanford, CA, USASummary: Background: Disparities in the health and economic burden of gonorrhoea have not been systematically quantified. We estimated population-level health losses and costs associated with gonococcal infection and sequelae in the United States. Methods: We used probability-tree models to capture gonorrhoea sequelae and to estimate attributable disease burden in terms of the discounted lifetime costs and quality-adjusted life-years (QALYs) lost due to incident infections acquired during 2015 from the healthcare system perspective. Numbers of infections in 2015 were obtained from a published gonorrhoea transmission model. We evaluated population-level disease burden, disaggregated by sex, age, race/ethnicity, and for men who have sex with men (MSM). We conducted a multivariate sensitivity analysis for key parameters. Findings: Discounted lifetime QALYs lost per incident gonococcal infection were estimated as 0.093 (95% uncertainty interval [UI] 0.022-0.22) for women, 0.0020 (0.0015-0.0024) for heterosexual men, and 0.0015 (0.00070-0.0021) for MSM. Discounted lifetime costs per incident infection were USD 261 (109-480), 169 (88-263), and 133 (50-239), respectively. At the population level, total discounted lifetime QALYs lost due to infections acquired during 2015 were 53,293 (12,326-125,366) for women, 621 (430-872) for heterosexual men, and 1,078 (427-1,870) for MSM. Total discounted lifetime costs were USD 150 million (64-277 million), 54 million (25-92 million), and 97 million (34-197 million), respectively. The highest total burden of both QALYs and costs at the population-level was observed in Non-Hispanic Black women, and highest burden per 1,000 person-years was identified in MSM among men and American Indian/Alaska Native among women. Interpretation: Gonorrhoea causes substantial health losses and costs in the United States. These results can inform planning and prioritization of prevention services. Funding: Centers for Disease Control and Prevention, Charles A. King Trust.http://www.sciencedirect.com/science/article/pii/S2667193X22001818Sexually transmitted infectionsGonorrhoeaDisparitiesQuality-adjusted life-years lostCosts |
| spellingShingle | Yunfei Li Minttu M. Rönn Ashleigh R. Tuite Harrell W. Chesson Thomas L. Gift Thomas A. Trikalinos Christian Testa Meghan Bellerose Katherine Hsu Andrés A. Berruti Yelena Malyuta Nicolas A. Menzies Joshua A. Salomon Estimated costs and quality-adjusted life-years lost due to N. gonorrhoeae infections acquired in 2015 in the United States: A modelling study of overall burden and disparities by age, race/ethnicity, and other factors The Lancet Regional Health. Americas Sexually transmitted infections Gonorrhoea Disparities Quality-adjusted life-years lost Costs |
| title | Estimated costs and quality-adjusted life-years lost due to N. gonorrhoeae infections acquired in 2015 in the United States: A modelling study of overall burden and disparities by age, race/ethnicity, and other factors |
| title_full | Estimated costs and quality-adjusted life-years lost due to N. gonorrhoeae infections acquired in 2015 in the United States: A modelling study of overall burden and disparities by age, race/ethnicity, and other factors |
| title_fullStr | Estimated costs and quality-adjusted life-years lost due to N. gonorrhoeae infections acquired in 2015 in the United States: A modelling study of overall burden and disparities by age, race/ethnicity, and other factors |
| title_full_unstemmed | Estimated costs and quality-adjusted life-years lost due to N. gonorrhoeae infections acquired in 2015 in the United States: A modelling study of overall burden and disparities by age, race/ethnicity, and other factors |
| title_short | Estimated costs and quality-adjusted life-years lost due to N. gonorrhoeae infections acquired in 2015 in the United States: A modelling study of overall burden and disparities by age, race/ethnicity, and other factors |
| title_sort | estimated costs and quality adjusted life years lost due to n gonorrhoeae infections acquired in 2015 in the united states a modelling study of overall burden and disparities by age race ethnicity and other factors |
| topic | Sexually transmitted infections Gonorrhoea Disparities Quality-adjusted life-years lost Costs |
| url | http://www.sciencedirect.com/science/article/pii/S2667193X22001818 |
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