Abstract
The lack of invasive pneumococcal disease (IPD) cost studies may underestimate the effect of pneumococcal polysaccharide conjugated vaccines (PCV). The objective of this study was to estimate the direct costs of hospitalized IPD cases. A prospective study was made in children aged <5 years diagnosed with IPD in two high-tech hospitals in Catalonia (Spain) between 2007–2009 (PCV7 period) and 2012–2015 (PCV13 period). Costs were calculated according to 2014 Catalan Health Service rates using diagnostic-related groups. In total, 319 and 154 cases were collected, respectively. Pneumonia had the highest cost (65.7% and 62.0%, respectively), followed by meningitis (25.8% and 26.1%, respectively). During 2007–2015, the costs associated with PCV7 serotypes (Pearson coefficient (Pc) = −0.79; p = 0.036) and additional PCV13 serotypes (Pc = −0.75; p = 0.05) decreased, but those of other serotypes did not (Pc = 0.23 p = 0.62). The total mean cost of IPD increased in the PCV13 period by 31.4% (€3016.1 vs. €3963.9), mainly due to ICU stay (77.4%; €1051.4 vs. €1865.6). During the PCV13 period, direct IPD costs decreased due to a reduction in the number of cases, but cases were more severe and had a higher mean cost. During 2015, IPD costs increased due to an increase in the costs associated with non-PCV13 serotypes and serotype 3 and this requires further investigation.
Highlights
Invasive pneumococcal disease (IPD) is a major cause of morbidity and mortality in children aged < 5 years and occurs mostly as pneumonia or other serious forms such as meningitis, bacteremia or osteoarticular infections
There was a significant decrease in the direct costs associated with PCV7 serotypes (Pc = −0.79; p = 0.036) but not in those associated with the serotypes added to the PCV13 (Pc = −0.75; p = 0.05) or in the total annual direct costs of invasive pneumococcal disease (IPD) (Pc = −0.63; p = 0.131)
After the introduction of PCV13, the direct costs associated with IPD in children aged < 5 years in Catalonia (Spain) decreased globally and for all clinical presentations due to a reduction in the
Summary
Invasive pneumococcal disease (IPD) is a major cause of morbidity and mortality in children aged < 5 years and occurs mostly as pneumonia or other serious forms such as meningitis, bacteremia or osteoarticular infections. Following the introduction of pneumococcal polysaccharide conjugated vaccines (PCV) in 2015, 3.7 million episodes of IPD were estimated in this age group, causing 294,000 deaths [2]. Despite this reduction, deaths attributable to Streptococcus pneumoniae in 2015 accounted for 11% of deaths in children aged < 5 years not infected with HIV. Incidence and mortality rates are higher in developing countries and most deaths occur in the African and Asian regions [3].
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