Adults <65 years with immunocompromising conditions are at high risk for pneumococcal infection. Limited studies have examined both the clinical and economic burden of pneumococcal disease in this population. We assessed pneumococcal disease rates, resource utilization and costs in US adults <65 years with immunocompromising conditions indicated for pneumococcal vaccination by ACIP.
A retrospective cohort study using medical and pharmacy claims from MarketScan Commercial Claims database (2012-2014) was conducted to compare rates and cost of all-cause pneumonia, pneumococcal pneumonia and invasive pneumococcal disease (IPD) in adults 19-64 years with and without immunocompromising conditions. Conditions of interest included chronic renal disease, cancer, asplenia, transplant and HIV.
35.7 million adults were included in the analysis. 83.0% had no immunocompromising condition; 3.2% had cancer, 0.1% asplenia, 0.9% transplant, 0.7% chronic renal disease, 0.2% HIV and 0.1% asplenia.
Adults with immunocompromising conditions had 4.8, 5.6 and 15.3 times the rate of all-cause, pneumococcal pneumonia and IPD compared to healthy older adults respectively. All-cause, pneumococcal pneumonia and IPD rates were highest in chronic renal and asplenia patients.
Per IPD episode, adults with immunocompromising conditions had slightly higher hospital visits compared to healthy adults – 0.8 vs. 0.6 visits – but substantially longer length of stay (6.3 vs 3.7 days) and greater costs ($33,028 vs. $$19,551). IPD costs were highest in asplenia ($41,165) and organ transplant patients ($35,990).
Adults aged 19-64 years with immunosuppressive conditions are at high risk of pneumococcal disease, consume more healthcare resources and incur greater costs.
H. K. Yang,
Merck & Co:
P. Mavros, Merck & Co: Employee , Salary
T. Petigara, Merck & Co: Employee , Salary