On June 12, 2014, In Case Studies Tags ,


Chronic infectious diseases represent a significant burden to healthcare resources, especially in countries where conditions are endemic and regions deemed high risk by international bodies like the WHO. While prophylactic vaccines are available to combat many infections, an unknown number of asymptomtic carriers remain that were infected prior to vaccine availability. Carriers eventually develop life-threatening and costly conditions as a direct result of their primary infection. However, if diagnosed sufficiently early, patients can be treated and in some cases cleared entirely of their infection. An international pharmaceutical company wishes to understand the potential burden of a chronic disease by country, as well as identify key populations at risk within each country that could be screened and subsequently treated. Country of birth has been identified as a significant risk factor for infection, with migrant populations contributing disproportionately to disease burden, especially in markets with low infection rates. Furthermore, areas with a high density of potential chronic disease sufferers must be mapped for each country.


Despite the disease of interest being notifiable, data availability across countries and regions differ enormously both in terms of disease definitions and data content. Some of the challenges to this analysis are routed in the disease itself, while others stem from a lack of comprehensive and consistent reporting criteria. To provide a robust analysis, it is necessary to understand recent changes to reporting criteria for the disease, and its impact on the data and the interpretation of the data. Furthermore, the chronic disease burden is impacted by: the case definition differences in the various national surveillance systems; estimations of the significant number of “missing” undiagnosed or asymptomatic cases; as well as the effect of varied vaccination programmes adopted in different years for different age cohorts. In addition to the complex challenges presented by the disease itself, an additional challenge stems from estimation of population flows between countries and their contribution to overall disease burden in a particular country

Big idea

Sourcing the most accurate and reliable information, verifying and interpreting it was a fundamental component of this analysis. Data sources need to be applicable and comparable across the markets of interest, allowing senior management to compare like for like. While a substantial amount of data was available, information from reputable international organisations was used to form a standardised pan-European structure for the analysis. Local data was used to supplement the analysis where available. A key component to this robust cross-country comparable analysis was the generation of a framework into which seemingly disparate data could be fed – thus making sense of the diverse case definitions and data reporting standards currently available globally.

Results & feedback

Black Swan Analysis delivered the analysis and its outputs to both central senior managers and brand teams at the local affiliate level. Insight into the make-up of disease populations and key locations of migrant populations provided local operating companies with a more informed view of their market. Another benefit of the analysis was the ability to leverage resources and materials aimed at reaching similar migrant populations by brand teams in different countries.