Economic burden of pneumococcal disease in children in Liguria, Italy

Amicizia, Daniela; Astengo, Matteo; Paganino, Chiara; Piazza, Maria Francesca; Sticchi, Camilla; Orsi, Andrea; Varlese, Federica; Hu, Tianyan; Petigara, Tanaz; Senese, Francesca; Prandi, Gian Marco; Icardi, Giancarlo; Ansaldi, Filippo

doi:10.1080/21645515.2022.2082205

Cited by 5 publications

(5 citation statements)

References 29 publications

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“…Several years have passed since Guest´s publication [ 53 ], and more recent studies assessing the direct cost per pneumonia episode in children in England are lacking. In a recent Italian study, Amicizia D., et al reported the median cost per ED visit or hospitalisation from 2012–2018 for PP (€3,323), and ACP (€1,850) [ 54 ], corresponding to £2,915 and £1,623 based on 2019 average exchange rate [ 50 ]. This contrasts with our study, where we found higher inpatient costs per episode in ACP compared to PP from 2003–2019, £3,549 (95% CI 3,405–3,693) for ACP versus £1,498 (95% CI 1,153–1,843) for PP.…”

Section: Discussionmentioning

confidence: 99%

Healthcare resource utilisation and cost of pneumococcal disease from 2003 to 2019 in children ≤17 years in England

et al. 2023

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Objective To estimate healthcare resource utilisation (HCRU) and costs associated with pneumococcal disease (PD) in children aged ≤17 years in England from 2003–2019. Methods A retrospective study in children aged ≤17 years was conducted using the Clinical Practice Research Datalink Gold primary care database and Hospital Episodes Statistics Admitted Patient Care database from 2003–2019. Episodes of invasive pneumococcal disease (IPD) were identified in hospital, pneumococcal pneumonia (PP) and all-cause pneumonia (ACP) episodes in primary care and in hospital, and acute otitis media (AOM) episodes in primary care. General practitioner (GP) visits and inpatient admission yearly rates were calculated per 1,000 persons. The average inpatient and primary care cost per episode were calculated. The Mann-Kendall test was used to assess monotonic time trends. Results 1,500,686 children were followed from 2003–2019. The highest average inpatient cost per episode [£34,255 (95%CI 27,222–41,288)] was in IPD, followed by ACP [£3,549 (95%CI 3,405–3,693)] and PP [£1,498 (95%CI 1,153–1,843)]. The highest primary care costs per episode were in AOM [£48.7 (95%CI 48.7–48.7)], followed by PP [£38.4 (95%CI 37.0–39.7)] and ACP [£28.6 (95%CI 28.2–29.1)]. The highest inpatient admission and GP visits yearly rates were observed in children aged <2 years. Across years, a significant decrease in GP visits yearly rates was observed for PP, ACP and AOM in children overall (p-value<0.001). A decrease in primary care costs was observed for ACP (p-value<0.001). There was an increasing trend in AOM primary care costs (p-value<0.001). No significant trends were observed in inpatient admission yearly rates in PP, ACP or IPD and inpatient costs per episode in PP, ACP and IPD. Conclusion From 2003–2019, primary care HCRU and costs decreased (except for PP cost), but no trends in inpatient HCRU and costs were observed. The economic burden of pneumonia, IPD and AOM remains substantial in children aged ≤17 years in England.

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Section: Discussionmentioning

confidence: 99%

Healthcare resource utilisation and cost of pneumococcal disease from 2003 to 2019 in children ≤17 years in England

et al. 2023

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“…Average cost per episode was reported for pneumonia and IPD as €345 and €4,206, respectively. Similarly, a study within the Liguria region of Italy reported an increase in the number and cost of emergency department visits and hospitalizations associated with IPD, ACP and AOM in children aged < 15 years between 2012–2018, while costs associated with PP decreased [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

“…Beyond Germany, Shiri et al recently reviewed the annual HCRU spend on PD including IPD, pneumonia and AOM from 2010 to 2018 in high-income countries and showed an increase in cost and resources used (including both out-and inpatient care) [9]. In addition, a study conducted in the Veneto region of Italy from 2010-2017 in children < 15 years old [39], showed that IPD burden did [40].…”

Section: Discussionmentioning

confidence: 99%

Healthcare resource utilization and cost of pneumococcal disease in children in Germany, 2014–2019: a retrospective cohort study

Podmore

Barnett

et al. 2023

Pneumonia

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Background Since the introduction of higher valency pneumococcal conjugate vaccines in 2009, recent estimates on the economic burden of pediatric pneumococcal disease (PD) in Germany have been lacking. This study estimates healthcare resource utilization (HCRU) and medical cost associated with PDs in children < 16 years old in Germany from 2014–2019. Methods A nationally representative sample from the Institute for Applied Health Research (InGef) German claims database was used, covering approximately 5% of the total German population. Episodes of pneumococcal pneumonia (PP), all-cause pneumonia (ACP), invasive pneumococcal disease (IPD), and acute otitis media (AOM) in children aged < 16 years were identified using ICD-10-GM codes. HCRU was estimated from annual rates of outpatient visits, outpatient antibiotic prescriptions and inpatient admissions, divided by person-years (PY) at-risk. Average direct medical costs per episode were estimated as the total cost of all HCRU, divided by the total number of episodes. The Mann–Kendall test was used to assess monotonic time trends from 2014–2019. Results During 2014–2019, 916,805 children aged < 16 years were followed up for a total of 3,608,716 PY. The average costs per episode for out-versus inpatient care associated with PP and ACP were €67 (95% CI 58–76) versus €2,606 (95% CI 1,338–3,873), and €63 (95% CI 62–63) versus €620 (95% CI 598–641), respectively. For IPD, the average medical cost per episode for out-versus inpatients were €30 (95% CI 19–42) versus €6,051 (95% CI 3,323–8,779), respectively. There were no significant trends in HCRU or costs for IPD or pneumonia over the study period, except for a significant reduction in ACP outpatient visits. A significant decrease in rate of outpatient visits and antibiotic prescribing for recurrent AOM was observed, in addition to an increase in rates of hospital admissions for simple AOM. This was paralleled by a significant increase in inpatient costs per episode for treating AOM overall, and simple AOM, over the study period. Conclusions The HCRU and cost per episode of pneumonia and IPD did not vary significantly from 2014–2019, but increased for AOM. The economic burden of pneumonia, IPD, and AOM remains substantial in Germany.

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“…Furthermore, a growing body of literature has focused on the emergence of residual burden, as serotypes of S . Pneumoniae not covered by available PCVs continue to circulate in the pediatric population [ 14 – 18 ]. As a consequence, higher-valent vaccines have been introduced in immunization programs, such as PCV10 (with additional serotypes 1, 5, and 7F) and PCV13 (with additional serotypes 3, 6A, and 19A) [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…The ongoing changes in etiology and emergence of non-vaccine serotypes are a reason for growing concern in the medical community around antibiotic-resistant bacteria as a major cause of treatment failure in pediatric patients with AOM [12,13]. Furthermore, a growing body of literature has focused on the emergence of residual burden, as serotypes of S. Pneumoniae not covered by available PCVs continue to circulate in the pediatric population [14][15][16][17][18]. As a consequence, higher-valent vaccines have been introduced in immunization programs, such as PCV10 (with additional serotypes 1, 5, and 7F) and PCV13 (with additional serotypes 3, 6A, and 19A) [5].…”

Section: Introductionmentioning

confidence: 99%

Clinical and economic burden of acute otitis media caused by Streptococcus pneumoniae in European children, after widespread use of PCVs–A systematic literature review of published evidence

Ricci Conesa,

Skröder,

Norton

et al. 2024

PLoS ONE

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Background Acute otitis media (AOM) is a common childhood disease frequently caused by Streptococcus pneumoniae. Pneumococcal conjugate vaccines (PCV7, PCV10, PCV13) can reduce the risk of AOM but may also shift AOM etiology and serotype distribution. The aim of this study was to review estimates from published literature of the burden of AOM in Europe after widespread use of PCVs over the past 10 years, focusing on incidence, etiology, serotype distribution and antibiotic resistance of Streptococcus pneumoniae, and economic burden. Methods This systematic review included published literature from 31 European countries, for children aged ≤5 years, published after 2011. Searches were conducted using PubMed, Embase, Google, and three disease conference websites. Risk of bias was assessed with ISPOR-AMCP-NPC, ECOBIAS or ROBIS, depending on the type of study. Results In total, 107 relevant records were identified, which revealed wide variation in study methodology and reporting, thus limiting comparisons across outcomes. No homogenous trends were identified in incidence rates across countries, or in detection of S. pneumoniae as a cause of AOM over time. There were indications of a reduction in hospitalization rates (decreases between 24.5–38.8% points, depending on country, PCV type and time since PCV introduction) and antibiotic resistance (decreases between 14–24%, depending on country), following the widespread use of PCVs over time. The last two trends imply a potential decrease in economic burden, though this was not possible to confirm with the identified cost data. There was also evidence of an increase in serotype distributions towards non-vaccine serotypes in all of the countries where non-PCV serotype data were available, as well as limited data of increased antibiotic resistance within non-vaccine serotypes. Conclusions Though some factors point to a reduction in AOM burden in Europe, the burden still remains high, residual burden from uncovered serotypes is present and it is difficult to provide comprehensive, accurate and up-to-date estimates of said burden from the published literature. This could be improved by standardised methodology, reporting and wider use of surveillance systems.

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Economic burden of pneumococcal disease in children in Liguria, Italy

Cited by 5 publications

References 29 publications

Healthcare resource utilisation and cost of pneumococcal disease from 2003 to 2019 in children ≤17 years in England

Healthcare resource utilisation and cost of pneumococcal disease from 2003 to 2019 in children ≤17 years in England

Healthcare resource utilization and cost of pneumococcal disease in children in Germany, 2014–2019: a retrospective cohort study

Clinical and economic burden of acute otitis media caused by Streptococcus pneumoniae in European children, after widespread use of PCVs–A systematic literature review of published evidence

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