OBJECTIVES: In Japan, there are approximately 1.9 million new CAP cases every year, with approximately 70% of cases involving patients who are >65 years old. The purpose of the current study was to estimate the excess costs of CAP in elderly people in Japan.

METHODS: This study included patients who were ≥65 years old, received any treatment every year from August 1, 2012 to July 31, 2015 obtained from an administrative database maintained by Medical Data Vision Co. Ltd. CAP case was defined as the admission with a confirmed diagnosis of pneumonia (ICD-10 code: J12-J18), and had a prescription for antibiotic treatment between August 1, 2013 and July 31, 2014. The control group was selected by patient’s characteristics and comorbidities using propensity score matching from patients who were not CAP. Total healthcare costs were calculated by combining all recorded treatment costs for a period of 1 years from CAP diagnosis date in CAP group or from February 1, 2014 in control group.

RESULTS: Among 45,371 patients in the database, we selected 294 CAP patients. Mean age was 79 (SD 7.5), and 60% was male in CAP group. Median total healthcare costs of CAP group and control group were $11,549 (IQR: $6,060-21,613) and $3,274 (IQR: $1,215-10,689), respectively. The difference of annual treatment costs between CAP group and control group was $9,406 (IQR: $6,755-12,056, p-value<0.01).

CONCLUSIONS: Elderly people had an excess costs approximately $9,500 per year due to CAP. In order to consider the appropriate distribution of medical resources, it is necessary to evaluate cost reduction effect by routine vaccination of pneumococcal vaccine for adult, or cost effectiveness by additional vaccination program. The results of this study can be useful for these evaluation.