Cost of chickenpox in Canada: Part II. Cost of complicated cases and totaleconomic impact

Objective. Primarily, to determine the direct medical costs and productivit y losses associated with complicated chickenpox (hospitalized cases) and, s econdarily, to quantify the overall economic burden of chickenpox in Canada . Methods. Direct medical resource consumption patterns were determined by ch art review of 160 otherwise healthy children and 40 children with leukemia hospitalized for chickenpox. Children were selected from the database of th e Immunization Monitoring Program Active (IMPACT), a network of 11 tertiary -care hospitals in Canada that collected information at the time of hospita lization from January 1991 to March 1996. An additional 26 healthy children hospitalized were recruited prospectively by IMPACT. Productivity losses ( time last from work and daily activities) were assessed by caregiver interv iews. Treatment costs were determined from the patient, Ministry of Health, and societal perspectives. Results. The average societal per case cost for complicated chickenpox in h ealthy children was $7060 and $8398, respectively, from the retrospective a nd prospective assessments. For children with leukemia, the direct medical cost was estimated at $7228. These costs were combined with a cost establis hed previously for uncomplicated chickenpox. The estimated yearly overall e conomic impact of chickenpox in Canada was $122.4 million, with $24.0 milli on attributable to Ministry of Health costs, assuming an estimated yearly i ncidence of 346 527 cases and a 0.54% rate of hospitalization for healthy c hildren. Conclusions. Direct medical costs are the major cost driver in the care of complicated chickenpox. However, in the context of the overall economic bur den of the disease, uncomplicated chickenpox is the major cost driver, cont ributing 89% to the total cost.