OBJECTIVES: Health interventions to reduce the clinical burden of pneumococcal disease (PD) could lead to substantial savings for the healthcare system. This study aimed to estimate the healthcare resource utilization (HCRU) and direct medical costs of PD in adults in Peru during 2022.

METHODS: A panel of experts was developed with five local infectious disease or critical care specialists from Ministry of Health (MoH) institutions with experience in treating PD-related syndromes (pneumococcal pneumonia [PP], bacteremia, and meningitis) in adults. The HCRU by category (lab/imaging tests, professional services, procedures, medications, and length of hospital stay [LoS]) and frequency were collected using a discussion guide through online interviews. To estimate costs, a micro-costing approach from the payer perspective was applied for each PD (uncomplicated and complicated) considering the reported average use of each resource and its respective unit cost in the MoH national tariff. Costs were converted to United States dollars (exchange rate $1USD=3.65 soles in June 2023).

RESULTS: The average LoS for PD ranged from 14.5 days for uncomplicated pneumonia to 55.5 days for complicated meningitis. For pneumonia, patients stayed an average of 4.6 days in the emergency room due to a shortage of hospital beds. The average cost per episode for outpatient pneumococcal pneumonia was $194, and for inpatient PP with and without complications was $2,038 and $10,450, respectively. For invasive pneumococcal disease, the most expensive average costs were bacteremia ($7,329), followed by complicated meningitis ($7,705), and uncomplicated meningitis ($5,778). The average cost for pneumococcal meningitis sequelae was $3,132. Among PD, the highest costs were driven by LoS, followed by lab/imaging tests, professional services, and medications.

CONCLUSIONS: PD in adults was associated with a high utilization of resources, hospital occupancy rates, and direct medical costs. HCRU and cost data reflecting local practices are critical to conducting economic evaluations that may inform pneumococcal vaccination policies.