Costi associati a diagnosi e trattamento delle patologie sostenute da S. pneumoniae nei soggetti di età ≥50 anni, in Il vaccino pneumococcico 13-valente per la prevenzione delle infezioni da S. pneumoniae in età adulta: una valutazione di HTA

[Autom. eng. transl.] The chapter, after presenting a review of international and national scientific literature, focuses on an analysis of the costs associated with the diagnosis and treatment of pathologies sustained by S. pneumoniae in subjects aged ≥50 years. As for the direct health costs of CAPs treated on an outpatient basis, the study estimated a total cost of over € 3,700,000 and an average annual cost per patient of approximately € 182. In particular, the total costs were as follows: about € 2,000,000 for antibiotic treatment, about € 1,200,000 for visits to GPs and about € 500,000 for diagnostics. These values have been calculated on the basis of incidence estimates, as in Italy the CAPs are not subject to notification and there is no surveillance system capable of providing reliable data. Moreover, in consideration of the lack of official data of indicative estimates and tariffs such as cost proxies. Hospitalization costs in subjects aged ≥50 years suffering from CAP and IPD attributable to S. pneumoniae in 2009 were over € 9,000,000, with an average annual cost per patient of € 3,479. The total costs were as follows: over € 6,600,000 for pneumonia, about € 1,200,000 for meningitis and over € 1,200,000 for septicemia. In reality, taking into consideration only the cases of illness certainly attributable to S. pneumoniae, that is those with laboratory confirmation, the hospitalization rates and the relative costs are likely to be underestimated, since in a large percentage of cases of illness or not being performed exactly the search for the etiological agent or etiology remains unrecognized despite laboratory investigations. Consequently, for a more reliable estimate of hospitalizations and related costs, unspecified pneumonia and bronchopneumonia were also considered. In fact, as evidenced in the literature, about one third of the cases of unspecified agent would certainly be ascribed to the pneumococcal etiology and therefore the total costs of hospitalizations for S. pneumoniae diseases in subjects aged ≥50 years would be higher than € 56.500 .000. In light of what emerged in this chapter, it is possible to note the high economic burden, both in terms of direct and indirect costs, of which S. pneumoniae diseases are responsible. It therefore follows the need to promote vaccination prevention policies in order to reduce the cases and costs associated with these diseases.