Direct Medical Costs of Dengue Fever in Vietnam: A Retrospective Study in a Tertiary Hospital

Biological invasions in France: Alarming costs and even more alarming knowledge gaps

The ever-increasing number of introduced species profoundly threatens global biodiversity. While the ecological and evolutionary consequences of invasive alien species are receiving increasing attention, their economic impacts have largely remained understudied, especially in France. Here, we aimed at providing a general overview of the monetary losses (damages caused by) and expenditures (management of) associated with invasive alien species in France. This country has a long history of alien species presence, partly due to its long-standing global trade activities, highly developed tourism, and presence of overseas territories in different regions of the globe, resulting in a conservative minimum of 2,750 introduced and invasive alien species. By synthesizing for the first time the monetary losses and expenditures incurred by invasive alien species in Metropolitan France and French overseas territories, we obtained 1,583 cost records for 98 invasive alien species. We found that they caused a conservative total amount ranging between US$ 1,280 million and 11,535 million in costs over the period 1993–2018. We extrapolated costs for species invading France, for which costs were reported in other countries but not in France, which yielded an additional cost ranging from US$ 151 to 3,030 millions. Damage costs were nearly eight times higher than management expenditure. Insects, and in particular the Asian tiger mosquito Aedes albopictus and the yellow fever mosquito Ae. aegypti, totalled very high economic costs, followed by non-graminoid terrestrial flowering and aquatic plants (Ambrosia artemisiifolia, Ludwigia sp. and Lagarosiphon major). Over 90% of alien species currently recorded in France had no costs reported in the literature, resulting in high biases in taxonomic, regional and activity sector coverages. To conclude, we report alarming costs and even more alarming knowledge gaps. Our results should raise awareness of the importance of biosecurity and biosurveillance in France, and beyond, as well as the crucial need for better reporting and documentation of cost data.

Cost of Illness Study of Patients with Dengue Hemorrhagic Fever at One of the Private Hospitals in Yogyakarta

Dengue hemorrhagic fever (DHF) caused by the dengue virus is one of the high-prevalence diseases in tropical countries, such as Indonesia. It has been highlighted that high-prevalence diseases are strongly correlated with high-treatment costs. In particular, Yogyakarta has been reported as one of the provinces with a high prevalence of DHF. This study aimed to estimate the cost of illness because of DHF and to analyze the correlation between the use of drugs with its cost and length of stay, with total hospital administrative cost at one of the private hospitals in Yogyakarta. A cross-sectional study was applied in this study by collecting patients’ medical record and financial data, such as demographic characteristic, medication, length of stay, and direct medical cost health-care perspective. The numbers of dengue patients were applied in this study by considering 87 patients and 143 patients with DHF in 2015 and 2016, respectively. Indirect medical costs were collected from a questionnaire by 20 respondents. Spearman’s statistical test was used in this study to conduct the bivariate test. The average direct medical cost from the perspective of health care in 2015 and 2016 in DHF patients with Badan Penyelenggara Jaminan Sosial (BPJS) insurance and non-BPJS insurance was US$243.6; US$363.41 and US$368.13; US$427.03. The indirect medical costs showed that the highest percentage productivity loss was US$70.98–212.95. Correlation between the numbers of drug with drug cost was significant (P < 0.05) with correlation coefficient (value ρ) of 0.527 and 0.603. Correlation between lengths of stay with the cost of hospitalization was significant (P < 0.05) with correlation coefficient (value ρ) of 0.375 and 0.562. It can be concluded that DHF has a relatively high cost of illness both in direct and indirect costs.

The Estimates of the Health and Economic Burden of Dengue in Vietnam

Dengue has been estimated to cause a substantial health and economic burden in Vietnam. The most recent studies have estimated that it is responsible for 39884 disability-adjusted life years (DALYs) annually, representing an economic burden of US$94.87 million per year (in 2016 prices). However, there are alternative burden estimates that are notably lower. This variation is predominantly due to differences in how the number of symptomatic dengue cases is estimated. Understanding the methodology of these burden calculations is vital when interpreting health economic analyses of dengue. This review aims to provide an overview of the health and economic burden estimates of dengue in Vietnam. We also highlight important research gaps for future studies.

Cost-of-Illness and the Health-Related Quality of Life of Patients in the Dengue Fever Outbreak in Hanoi in 2017

Dengue fever (DF) outbreaks occur intermittently in Vietnam, and the most recent epidemic happened in 2017. However, attempts to measure the burden of DF in relation to the quality of life and the cost of treatment for patients during an epidemic period are constrained. This study explored the health-related quality of life (HRQOL) and the cost of illness among patients with dengue fever in Vietnam. A cross-sectional study was conducted in Bach Mai Hospital from September to November 2017. The EuroQol-5 dimensions-5 levels (EQ-5D-5L) was used to measure HRQOL. Cost-of illness was measured by collecting data about the direct medical cost, the non-medical cost, and the indirect cost. Among 225 patients, most of the participants experienced problems regarding mobility (62.3%), self-care (71.8%), usual activities (64.6%), and anxiety/depression (64.1%). The mean EQ-5D index was 0.66 (SD = 0.24). The median cost of illness for inpatient and outpatient groups were US $110.10 (IQR = US $4.40–1200.00) and US $36.10 (IQR = US $1.80–816.30), respectively. Indirect costs accounted for a major proportion in both groups. Lower-skilled workers and those with a higher severity of the disease had significantly lower HRQOL. Meanwhile, people who were inpatients, had comorbidities, had higher incomes, and who experienced a longer disease duration, had a higher cost of treatment. In conclusion, high costs and severe health deterioration, especially in psychological dimensions, were found in patients with DF in Vietnam. Strengthening primary health care services and communication campaigns are necessary to relieve the burden of diseases and could possibly contribute to effective DF control and prevention strategies.