Clinical and economic burden of pneumococcal disease in US adults aged 19–64 years with chronic or immunocompromising diseases: an observational database study

Abstract

BackgroundDespite the widespread availability of pneumococcal vaccines, rates of pneumococcal disease are disproportionately high in adults with chronic and immunocompromising conditions. This study investigated pneumococcal disease rates and associated resource utilization and costs in this group.MethodsA retrospective, observational study was conducted using the Truven Health MarketScan® Commercial Claims and Encounters database. The study population was adults aged 19–64 years with continuous health plan enrollment for at least one year before and at least one day after January 1st 2012, 2013 and/or 2014. Medical conditions were identified using ICD-9-CM diagnosis codes and grouped into at-risk (chronic) and high-risk (immunocompromising) conditions. Pneumococcal disease was stratified into all-cause pneumonia (ACP) and invasive pneumococcal disease (IPD).ResultsThirty-six million adults aged 19–64 years were included in the study. 17% had a condition that put them at increased risk for pneumococcal disease. Rates of ACP and IPD in adults with at-risk conditions were 3.6 and 4.6 times the rate in healthy adults, respectively, and 5.3 and 10.5 for adults with high-risk conditions. Risk was particularly high in adults with ≥2 medical conditions: rates of ACP and IPD were 8.1 and 10.6 times higher in adults with at-risk conditions than healthy adults and 6.3 and 13.4 times higher in adults with high-risk conditions, respectively. Resource use and costs were substantially higher per episode of ACP in at-risk and high-risk adults, with costs reaching $6,534 and $9,168, compared to $4,725 for healthy adults.ConclusionsPneumococcal disease rates in at-risk and high-risk adults are significantly higher than healthy adults leading to substantial economic burden.Electronic supplementary materialThe online version of this article (10.1186/s12879-018-3326-z) contains supplementary material, which is available to authorized users.

Why Infants Rarely Die of COVID-19 and Morbidity and Mortality Rates Vary by Location: Pneumococcal and Hib Vaccinations as Possible Means to Mitigate Future Pandemics

“…Because the more broadly vaccinations are implemented, the stronger both individual immunity and herd immunity becomes, the greater the benefits for everyone. Indeed, every study that has been done of the economic impact of pneumococcal and Hib vaccination programs has shown that for every billion dollars invested in vaccination, several billions are saved in critical care costs for elderly and atrisk patients (Wateska, et al, 2020;Richter, et al, 2019;Zhang, et al, 2018;Ciruela, et al, 2018;Baldo, et al, 2016;Arencibia Jiménez, et al, 2014;Isaacman, et al, 2008 ). Actual savings may be significantly greater since these economic studies have not included the benefits that may accrue from protection against the global economic devastation that a coronavirus or influenza pandemic can cause by shutting down businesses and harming trade.…”

“…* Gervaix, et al, 2014;^ Mereckiene, 2017;+ WHO, 2020;> Blank, et al, 2018; # estimated from accumulated yearly vaccinations. Austria (Richter, et al, 2019); France (Contou, et al, 2020); Germany (Theidel, et al, 2013;Pletz, et al, 2016); Greece (Maraki, et al, 2018);US (FluVaxView;Wateska, et al, 2020;Zhang, et al, 2018;Sings, 2017;Williams, et al, 2016); UK (Tolman, et al, 2016); Australia (Hull, et al, 2019;Yang, et al, 2019;Dyda, et al, 2016); Japan (Naito, et al, 2020;Takeda, et al, 2019;Shibata, et al, 2019;Kajikawa, et al, 2019;Kumar, et al, 2014); S. Korea (Song, et al, 2013;Yang, et al, 2015;Park, et al, 2019;Yang, et al, 2020); Italy (Giammanco, et al, 2018;Baldo, et al, 2016;Tozzi, et al, 2014;Fedson, 2011); Spain (Ciruela, et al, 2018;Arencibia Jiménez, et al, 2014;Fedson, 2011); Canada (Kaplan, et al, 2019;Farmanara, et al, 2018); Portugal (Kislaya, et al, 2019); Netherlands (Vestjens, et al, 2019); Switzerland ** NB no current data available (Büla, et al, 1996). (TABLE 1).…”

Serotype Distribution, Antimicrobial Susceptibility, and Multilocus Sequencing Type (MLST) of Streptococcus pneumoniae From Adults of Three Hospitals in Shanghai, China

“…Chronic diseases and immunocompromise (IC), common in elderly population, are considered as two important risk factors in pneumococcal disease (PD) (Gil-Prieto et al, 2016). It has been presented as a significant cause which leads to substantial economic burden in at-risk and high-risk adults (Zhang et al, 2018).…”

More targeted use of oseltamivir and in-hospital isolation facilities after implementation of a multifaceted strategy including a rapid molecular diagnostic panel for respiratory viruses in immunocompromised adult patients

“…Moreover, the number of immunocompromised patients is increasing due to ageing of the population, increased prevalence of chronic diseases as well as treatment with immunosuppressive agents [4,5]. Although immunocompromised patients have similar etiologies of acute RTI when compared to immunocompetent patients [6], they more often have a complicated course of the disease leading to high healthcare burden, especially in secondary and tertiary care settings [7,8]. Within the respiratory viral season, in-hospital isolation facilities are often falling short due to the high number of patients with suspected https://doi.org/10.1016/j.jcv.2019.04.003 Received 2 January 2019; Received in revised form 4 April 2019; Accepted 6 April 2019 viral infections and immunocompromised patients with prolonged viral shedding [9,10].…”