Enteroviral meningitis. Cost of illness and considerations for the economic evaluation of potential therapies.

With limited financial resources available, it is now becoming more acceptable to evaluate medical innovations in terms of incremental economic value. The purpose of this paper is to provide an overview of enteroviral meningitis and to summarise the economic literature to identify relevant costs and outcomes. Enteroviral meningitis is the most common cause of aseptic meningitis, and occurs in 4.5 to 30 per 100,000 population annually with a duration of illness lasting between 1 and 2 weeks after onset of initial symptoms. The major resource categories that contribute to the overall direct costs of management of enteroviral meningitis include physician visits, hospital admissions, emergency room visits, medications, procedures such as lumbar puncture and computed tomography scans, re-hospitalizations and follow-up physician visits. Indirect costs are incurred in terms of school or work days missed or restrictions in daily activities. The total direct costs of an episode of enteroviral meningitis range from $US450 for outpatients to $US5093 for inpatient management (1996 values). The total indirect costs of an episode of enteroviral meningitis are estimated to be equivalent to 5 to 7 activity-restricted days. Interventions that improve early diagnosis or decrease the duration and need for hospitalisation will significantly affect the cost of managing enteroviral meningitis. Additional prospective studies are needed to study the impact of interventions on the burden of enteroviral meningitis.