Abstract
BackgroundDespite the widespread availability of pneumococcal vaccines, rates of pneumococcal disease are disproportionately high in adults with chronic and immunocompromising conditions. This study investigated pneumococcal disease rates and associated resource utilization and costs in this group.MethodsA retrospective, observational study was conducted using the Truven Health MarketScan® Commercial Claims and Encounters database. The study population was adults aged 19–64 years with continuous health plan enrollment for at least one year before and at least one day after January 1st 2012, 2013 and/or 2014. Medical conditions were identified using ICD-9-CM diagnosis codes and grouped into at-risk (chronic) and high-risk (immunocompromising) conditions. Pneumococcal disease was stratified into all-cause pneumonia (ACP) and invasive pneumococcal disease (IPD).ResultsThirty-six million adults aged 19–64 years were included in the study. 17% had a condition that put them at increased risk for pneumococcal disease. Rates of ACP and IPD in adults with at-risk conditions were 3.6 and 4.6 times the rate in healthy adults, respectively, and 5.3 and 10.5 for adults with high-risk conditions. Risk was particularly high in adults with ≥2 medical conditions: rates of ACP and IPD were 8.1 and 10.6 times higher in adults with at-risk conditions than healthy adults and 6.3 and 13.4 times higher in adults with high-risk conditions, respectively. Resource use and costs were substantially higher per episode of ACP in at-risk and high-risk adults, with costs reaching $6,534 and $9,168, compared to $4,725 for healthy adults.ConclusionsPneumococcal disease rates in at-risk and high-risk adults are significantly higher than healthy adults leading to substantial economic burden.
Highlights
Despite the widespread availability of pneumococcal vaccines, rates of pneumococcal disease are disproportionately high in adults with chronic and immunocompromising conditions
The associated economic burden is substantial: it is estimated that hospitalizations for pneumococcal pneumonia will double between 2004 and 2040 and the total economic burden will increase by $2.5 billion annually [6]
The objective of our study was to provide updated estimates of pneumococcal disease rates, and to provide more detailed estimates of healthcare resource utilization and costs in United States (US) adults aged 19–64 years with chronic and immunocompromising conditions recommended for pneumococcal vaccination by the Advisory Committee on Immunization Practices (ACIP)
Summary
Despite the widespread availability of pneumococcal vaccines, rates of pneumococcal disease are disproportionately high in adults with chronic and immunocompromising conditions. This study investigated pneumococcal disease rates and associated resource utilization and costs in this group. Invasive pneumococcal disease (IPD) comprises bacteremic pneumococcal pneumonia, meningitis and bacteremia without focus, whereas non-invasive disease includes non-bacteremic pneumococcal pneumonia, otitis media, sinusitis and bronchitis [2, 3]. IPD is a leading cause of morbidity and mortality [4], in adults aged 18–64 years with chronic or immunocompromising conditions and those aged 65 and over [5]. The associated economic burden is substantial: it is estimated that hospitalizations for pneumococcal pneumonia will double between 2004 and 2040 and the total economic burden will increase by $2.5 billion annually [6]
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