BACKGROUND: Dominican Republic has a fragmented Health Care System. National Health Insurance (SENASA) is the main principal institution responsible for Public Health Care. SENASA has 2 regimes: contributory and subsidized. SENASA is responsible for public care of approximately 45% of the total population of Dominican Republic and, the contributory regime is responsible for public care at least 10% of that population OBJECTIVES: Determine cost of illness to treat bacterial pneumonia in the adult population and its different clinical and economical outcomes from a Public Perspective.

METHODS: Micro-costing technique (bottom-up) was used to determine the cost of illness. For this analysis, only the direct medical cost of SENASA database in 2017-2018 was considered. These costs were from a contributory regime perspective RESULTS: The average cost for Community-Acquired Pneumonia (CAP) where patients required outpatient attention, hospital attention or intensive care unit (ICU) attention was: US$ 84,06; US$ 550,74 and US$ 955,68 respectively. The average cost for Hospital-Acquired Pneumonia (HAP) where patients required a second line of treatment or ICU was: US$ 634,56 and US$ 1.672,04 respectively. The average cost of invasive pneumonia/sepsis was US$ 4.010,01.

CONCLUSIONS: The treatment of bacterial pneumonia represents a substantial economic impact for the Health System of the Dominican Republic. It is necessary to consider a prevention strategy that includes vaccination against bacterial pneumonia for the adult population, which can not only reduce the economic impact on the health system, but also prevent events that compromise patients’ quality of life and also, contribute the decrease bacterial resistance.