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Observational Study
. 2018 Aug 29;18(1):436.
doi: 10.1186/s12879-018-3326-z.

Clinical and economic burden of pneumococcal disease in US adults aged 19-64 years with chronic or immunocompromising diseases: an observational database study

Dongmu Zhang  1 , Tanaz Petigara  1 , Xiaoqin Yang  2
Affiliations
Observational Study

Clinical and economic burden of pneumococcal disease in US adults aged 19-64 years with chronic or immunocompromising diseases: an observational database study

Dongmu Zhang et al. BMC Infect Dis. .

Abstract

Background: 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.

Methods: A 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).

Results: Thirty-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.

Conclusions: Pneumococcal disease rates in at-risk and high-risk adults are significantly higher than healthy adults leading to substantial economic burden.

Keywords: Health care costs; Health resources; Immunocompromised patients; Pneumococcal; Pneumococcal infections; Pneumonia; Risk factors.

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Conflict of interest statement

Ethics approval and consent to participate

IRB approval was not obtained because this study was an analysis of de-identified secondary data [23].

Consent for publication

Not applicable.

Competing interests

Conflict of interest statement: Drs. Yang and Petigara are employees of Merck & Co., Inc., Kenilworth, NJ, USA,.

Dr. Zhang was a Merck & Co., Inc., Kenilworth, NJ, USA, employee when the study was conducted.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Mean cost per episode of ACP and IPD in healthy and at-risk adults 19–64 years. *P < 0.0001. ACP all-cause pneumonia, IPD invasive pneumococcal disease
Fig. 2
Fig. 2
Mean cost per episode of ACP and IPD in healthy and high-risk adults 19–64 years. *P < 0.0001. ACP all-cause pneumonia, IPD invasive pneumococcal disease
See this image and copyright information in PMC

References

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