Direct Costs of Pneumococcal Disease in the United States - A Targeted Literature Review
Author(s)
Min Huang, PhD1, Jipan Xie, MD, PhD2, Walter A. Orenstein, MD3, Hela Romdhani, PhD4, Yan Song, PhD4, Elamin Elbasha, BSc, MA, PhD5, Matthew S. Kelly, MD, MPH6.
1Sr. Principal Scientist, Merck & Co. Inc, North Wales, PA, USA, 2XL Source, Inc., Los Angeles, CA, USA, 3School of Medicine, Emory University, Atlanta, GA, USA, 4Analysis Group, Inc., Boston, MA, USA, 5Merck & Co., Inc., Rahway, NJ, USA, 6Division of Pediatric Infectious Diseases, Duke University School of Medicine, Durham, NC, USA.
1Sr. Principal Scientist, Merck & Co. Inc, North Wales, PA, USA, 2XL Source, Inc., Los Angeles, CA, USA, 3School of Medicine, Emory University, Atlanta, GA, USA, 4Analysis Group, Inc., Boston, MA, USA, 5Merck & Co., Inc., Rahway, NJ, USA, 6Division of Pediatric Infectious Diseases, Duke University School of Medicine, Durham, NC, USA.
Presentation Documents
OBJECTIVES: Understanding the costs associated with pneumococcal disease (PD) is essential for assessing its economic burden and the cost-effectiveness of pneumococcal vaccines. This study aims to summarize the direct medical costs of PD in the US.
METHODS: A targeted literature review was conducted using MEDLINE (2010-2024) to identify original studies estimating cost per PD episode. Mean cost estimates (or median, if mean was not reported) were extracted and adjusted to 2023 USD using the medical care component of the Consumer Price Index. Median values and interquartile ranges (IQRs) across studies were summarized separately for children (0-17 years) and adults (≥18 years).
RESULTS: Thirty-six studies were included: 15 focused on children, 16 on adults, and 4 on both. Eleven studies assessed costs for invasive pneumococcal disease (IPD), 27 for pneumonia, and 2 for acute otitis media (AOM). Median direct costs per episode in children were $42,921 (IQR: $32,001-$93,156) for IPD, $7,905 ($5,537-13,953) for inpatient pneumonia (IP), $541 ($440-$621) for outpatient pneumonia (OP), $2,619 ($1,164-$3,511) for unspecified pneumonia, and $313 ($299-$427) for AOM. For adults, the corresponding costs were $40,128 (21,575-$53,608) for IPD, $19,421 ($14,745-$27,407) for IP, $1,595 ($792-$2,586) for OP, and $6,054 ($4,168-$10,559) for unspecified pneumonia. Variability across studies was largely attributed to differences in methodology, including approaches to case identification, episode definitions, and the perspectives adopted.
CONCLUSIONS: PD imposes substantial economic burdens on the healthcare system, particularly IPD and IP. Adults appear to incur higher costs per pneumonia episode than children. The considerable variability in estimated costs across studies highlights the importance of considering the methodologies of source studies, including health state definitions and model perspectives, to ensure alignment with those applied in economic evaluations.
METHODS: A targeted literature review was conducted using MEDLINE (2010-2024) to identify original studies estimating cost per PD episode. Mean cost estimates (or median, if mean was not reported) were extracted and adjusted to 2023 USD using the medical care component of the Consumer Price Index. Median values and interquartile ranges (IQRs) across studies were summarized separately for children (0-17 years) and adults (≥18 years).
RESULTS: Thirty-six studies were included: 15 focused on children, 16 on adults, and 4 on both. Eleven studies assessed costs for invasive pneumococcal disease (IPD), 27 for pneumonia, and 2 for acute otitis media (AOM). Median direct costs per episode in children were $42,921 (IQR: $32,001-$93,156) for IPD, $7,905 ($5,537-13,953) for inpatient pneumonia (IP), $541 ($440-$621) for outpatient pneumonia (OP), $2,619 ($1,164-$3,511) for unspecified pneumonia, and $313 ($299-$427) for AOM. For adults, the corresponding costs were $40,128 (21,575-$53,608) for IPD, $19,421 ($14,745-$27,407) for IP, $1,595 ($792-$2,586) for OP, and $6,054 ($4,168-$10,559) for unspecified pneumonia. Variability across studies was largely attributed to differences in methodology, including approaches to case identification, episode definitions, and the perspectives adopted.
CONCLUSIONS: PD imposes substantial economic burdens on the healthcare system, particularly IPD and IP. Adults appear to incur higher costs per pneumonia episode than children. The considerable variability in estimated costs across studies highlights the importance of considering the methodologies of source studies, including health state definitions and model perspectives, to ensure alignment with those applied in economic evaluations.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE179
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
STA: Vaccines