OBJECTIVES: To determine the economic burden of pneumonia among adults aged 50 and older.

METHODS: We exhaustively searched MEDLINE, EMBASE, Web of Science and Cochrane Library for primary studies published from January 2010 to December 2020, which investigated the economic burden of pneumonia in aged adults. Data on number of cases, direct and indirect costs were extracted and descriptively summarized. Risk of bias were assessed.

RESULTS: Seven studies were included from the 5,562 searched citations. Two of them reported evidence from middle-income economies while the others reported evidence from high income regions. Five of the included studies were cost-of-illness studies while the others were economic evaluations. All of the five studies reported the perspectives used national health system perspective for economic investigations.

CONCLUSIONS: The evidence on economic burden of pneumonia among aged adults were scarce. The limited reports showed lower direct medical costs per case for hospitalized pneumococcal pneumonia in middle income countries, which could be attributed to the lower labor costs of health professionals and service procedures. Across high-income regions, where treatment guidelines were commonly introduced, direct costs of hospitalized pneumococcal pneumonia varied a lot, which could be partially related to the varieties in the standardization and qualities of health care services.