Healthcare resource use and costs associated with episodes of laboratory confirmed invasive pneumococcal disease in adults in Finland 2016–2022

BACKGROUND: Streptococcus pneumoniae is a common mortality and morbidity causing pathogen worldwide which can lead to both invasive and noninvasive pneumococcal disease. Invasive pneumococcal disease (IPD) is a severe form of pneumococcal infection manifesting, for example, as bacteremia, sepsis, or meningitis. This study evaluated the clinical and economic burden caused by laboratory confirmed IPD in the population aged ≥18 years in Finland 2016-2022. METHODS: IPD episodes were identified from the National Infectious Disease Register. Healthcare resource use (HCRU) was obtained from the Finnish care registers and linked to each 90-day episode. Case-fatality was determined within 30 days since the first S. pneumoniae culture. HCRU, including hospitalizations and outpatient visits, was valued according to the national healthcare unit costs. The direct costs associated with HCRU, adjusted to the 2023 level, were calculated per episode and per year, and stratified by patient's age. RESULTS: Overall, 4018 IPD episodes were identified, with the median age of patients being 67 years. Meningitis was identified for 2.9 % of the episodes. Case-fatality was 9.7 % in all adults and increased steeply with age, from 3.2 % in 18-49-year-olds to 26.7 % in ≥85-year-olds. The average costs per episode were €9118 (95 % confidence interval [CI] €8802-€9419), with the highest costs (€9953; 95 % CI €9242-€10,562) observed in the 65-74-year-olds. In all adults, the mean total annual costs associated with IPD episodes were €5.23 million (95 % CI €3.66-€6.57 million). Inpatient care comprised 94 % of the total costs. In adults aged 65 and older, serotype coverage for pneumococcal conjugate vaccines PCV13, PCV20 and PCV21(V116) was 47.5 %, 66.5 %, 77.0 %, respectively. CONCLUSIONS: This study demonstrates the significant burden of IPD in the Finnish adult population. Wider vaccination against S. pneumoniae has the potential to substantially reduce the health and economic burden associated with pneumococcal diseases especially among older adults.