ESTIMATING THE COSTS OF INVASIVE PNEUMOCOCCAL DISEASE IN OLDER CHILDREN AND ADULTS IN SELECTED COUNTRIES OF LATIN AMERICA

Purpose:

Streptococcus pneumoniaeis a leading cause of invasive pneumococcal disease (IPD) in older children and adults, with considerable morbidity and mortality and health system costs in the region of Latin America. The present study aims to fill important gaps in our understanding of the economic burden of IPD in this population. 

Methods:

We developed an Excel-based model to provide estimates of the economic burden of IPD (pneumonia, meningitis) among individuals five years and older in Argentina, Brazil, Chile, Colombia, and Uruguay. We synthesized available data from the published literature, identified national treatment guidelines and conducted physician surveys to establish treatment practices of IPD in three age groups: 5-17 year olds, 18-64 year olds and 65+ year olds. 

Results:

A total of 15 studies (5 published; 10 unpublished) presenting IPD cost analysis or cost-effectiveness data from 8 countries of the region were identified. Data on IPD economic burden among ≥ 5 year olds in the literature were limited. A total of 153 physicians responded to the surveys. The total direct medical cost per case for treatment of pneumonia ranged from US$993 to US$3,132 in older children (5-17 years), from US$1,274 to US$3,247 in adults (18-64 years) and from US$1,746 to U$3,535 in elderly (65+ years). Higher costs incurred in the elderly due to higher level of resources used for treating pneumonia. Across countries, treating IPD was more expensive in Chile than in Colombia, Argentina, Brazil and Uruguay, due to higher hospital care costs. Overall, the costs of hospital stay accounted for 45% of the total treatment costs in these countries. Across the region, the health care costs of IPD ranged from US$8.2 million to US$14.1 million, with higher costs detected in the elderly. Healthcare spending for IPD in the population age 5 years and above in the region as a percentage of GDP was estimated at 0.1%, compared to the reported 8-10% of GDP spent on healthcare overall in the region. 

Conclusions:

The present study highlights the important knowledge gap on the economics of IPD for people 5 years of age and older in the region. Findings of the economic burden analysis support the conclusion that IPD poses a sizable burden among individuals aged 5 years and above in the five countries studied.