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Economic burden high for group A streptococcal pharyngitis

Group A streptococcal (GAS) pharyngitis among children costs society up to $539 million per year, with almost one-half due to nonmedical costs, according to an extrapolation of data collected from 135 parents. Phase I trials have been completed in the United States on a multivalent vaccine against GAS strains that cause pharyngitis, invasive disease and rheumatic fever. Costs of implementing the vaccine have not been compared yet with the burden of GAS morbidity on society. This study looked at the morbidity, medical costs and nonmedical costs associated with GAS pharyngitis in school-aged children. Parents of children diagnosed with GAS pharyngitis at two pediatric practices in the Boston area were interviewed by phone about duration of symptoms, outpatient and emergency department visits, hospitalizations, use of antibiotics and other drugs, and time missed from work or school. Results showed the mean time from the initial visit to resolution of symptoms was 4.5 days. Children missed an average of 1.9 days of school or child care, and 42% of parents missed a mean of 1.8 days of work. Eighty-seven percent of children had one outpatient visit, while 13% had two or more visits. None required hospitalization. Seventy-nine percent were given prescriptions for penicillin or amoxicillin. In addition, 57% received ibuprofen, 21% received acetaminophen, 15% received both pain relievers, and 33% used other overthe-counter medications such as throat lozenges. The mean cost per case of group A strep was $205 (medical $118; nonmedical $87). Extrapolating these results to the U.S. population, the cost of GAS pharyngitis in children ranges from $224 million to $539 million per year. The authors concluded that the economic benefits of a GAS vaccine would be significant. Economic burden high for group A streptococcal pharyngitis