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. 2024 Dec 31;20(1):2409510.
doi: 10.1080/21645515.2024.2409510. Epub 2024 Oct 18.

Clinical and economic burden of otitis media in children under 5 years of age in the United States: A retrospective study

Lilia Ben Debba  1 , Dominique Derreumaux  1 , Germain Lonnet  1 , Laura Taddei  2 , Michael Scherbakov  1
Affiliations

Clinical and economic burden of otitis media in children under 5 years of age in the United States: A retrospective study

Lilia Ben Debba et al. Hum Vaccin Immunother. .

Abstract

Reductions in all-cause otitis media (OM) following widespread pneumococcal conjugate vaccine use have plateaued. Granular burden of disease data are needed to guide evaluation and implementation of new measures targeting OM prevention. We conducted a retrospective study to assess the incidence and treatment costs of OM, tympanostomy tube placement (TTP), and hearing loss in children aged <5 years in the United States (US). OM episodes and TTP between 2016 and 2017 were identified in IBM MarketScan Commercial Claims and Encounters, Medicare Supplemental and Coordination of Benefits, and Multi-Medicaid databases using diagnosis codes (ICD-10). The incidence rate per 100,000 person-years (IR) of OM in <5-year-olds was 62,726 in Commercial/Medicare databases and 55,874 in Medicaid. IRs peaked at 9-<12 months (115,552 and 110,960, respectively). Approximately 5% and 4% of OM episodes in the respective databases had TTP (IR 3233 and 2404). Around 2% of children with OM had hearing loss (IR 1468 and 1109, respectively), of whom 41% had TTP. We estimated that there were 11.1 million OM episodes in 2020 costing USD 4.8 billion. 243,618 children were estimated to have OM with hearing loss at a direct total cost of USD 637 million, or 13% of the overall cost. The clinical and economic burden attributable to OM in the US was high in children aged <5 years during the study period. Novel approaches are needed to improve and broaden vaccine-induced protection against OM and its complications. The study results could guide policymakers considering age-specific interventions to reduce the OM burden.

Keywords: Cost; Incidence; ear infection; epidemiology; hearing loss; otitis media; pneumococcal conjugate vaccine; tympanostomy tube placement; vaccine.

Plain language summary

What is the context? Pneumococcal vaccines administered to young infants can prevent some, but not all cases of middle ear infection (otitis media).We assessed the burden of middle ear infection in children aged less than 5 years in the United States (US) and estimated the cost to the healthcare system.This study also looked at the incidence of middle ear infection with hearing loss and the costs associated with its treatment.What is new? We estimated the burden of hearing loss in children with otitis media.The study showed that middle ear infection is still a very common disease in young children, especially between 9 and 12 months of age.Most children with middle ear infection are treated as outpatients. Around 4% have a ventilation tube inserted and around 2% have middle ear infection with hearing loss.We estimated that the cost of treating middle ear infection in the US is USD 4.8 billion.What is the impact? Middle ear infection remains a common disease in young children.New methods to prevent middle ear infection need to be given early in life because disease rates start to increase from the age of 6 months.

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Conflict of interest statement

DD, LT, and MS are employed by GSK and LT and MS hold financial equities in GSK. LBD is a consultant for GSK. GL was employed by Business and Decision at the time of the study and is now employed by GSK. All authors declare no other financial or non-financial relationships and activities.

Figures

Figure 1.
Figure 1.
Study design figure.
Figure 2.
Figure 2.
Incidence rates of otitis media in children less than 5 years of age (Marketscan, 2016–2017).
Figure 3.
Figure 3.
Estimate of the distribution of total medical costs associated with otitis media in the United States in 2020.
See this image and copyright information in PMC

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