Kelly D. Johnson, United States of America

Merck & Co Vaccines

Poster Author Of 3 e-Posters

Online Abstracts Vaccines - Pneumococcal Vaccines Development C1 Pneumococcal Vaccines Development
Online Abstracts Population Sciences - Epidemiology, Economics, and Mathematical Modelling D1 Epidemiology, Economics, and Mathematical Modelling
Online Abstracts Vaccines - Pneumococcal Vaccines Development C1 Pneumococcal Vaccines Development

Presenter of 3 Presentations

HEALTH AND ECONOMIC IMPACT OF 15-VALENT PNEUMOCOCCAL CONJUGATE VACCINE (PCV15) SEROTYPES IN ADULTS 65 YEARS AND OLDER IN THE U.S. (ID 744)

Abstract

Background

This analysis quantifies the epidemiologic and economic burden of pneumococcal disease attributable to 15-valent pneumococcal conjugate vaccine (PCV15) serotypes in a hypothetical cohort of US adults aged 65 years and older in the US.

Methods

A Markov model was used to estimate pneumococcal disease cases, deaths and costs attributable to PCV15 serotypes. A cohort of unvaccinated adults aged ≥65 years from 2017 were tracked until death. Economic burden was estimated from a payer perspective, by multiplying the number of inpatient/outpatient visits by the cost per inpatient/outpatient visits. Costs were discounted at 3% per year.

Results

An estimated 74,956 cases of IPD; 10,336 cases of IPD related deaths; 2,286,581 cases of NBPP hospitalizations and 135,566 cases of NBPP related deaths were attributable to PCV15 serotypes in adults aged ≥65 years in the U.S. Total lifetime discounted healthcare costs attributable to PCV15 serotypes were estimated to be approximately $19.9 million. 36.3% of these cases, deaths and costs were attributable to serotypes 22F and 33F and 42.4% were attributable to serotype 3.

Conclusions

PCV15 serotypes contribute to substantial health and economic burden of pneumococcal disease among older adults (aged ≥65 years) in the U.S., majority of which is attributable to the serotypes 3, 22F, and 33F.

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CLINICAL AND ECONOMIC BURDEN OF PNEUMOCOCCAL DISEASE AMONG INDIVIDUALS AGED 16 YEARS AND OLDER IN GERMANY (ID 748)

Abstract

Background

The study assessed the incidence rate of all-cause pneumonia (ACP) and invasive pneumococcal disease (IPD) and associated direct medical costs among individuals aged 16 years and older in Germany.

Methods

ACP and IPD were identified using ICD-10-GM codes in the InGef database from 2014 to 2017. Incidence rate was expressed as the number of episodes per 100,000 person-years. Direct medical costs were estimated as the total cost of all inpatient and outpatient visits, divided by the total number of episodes.

Results

The annual incidence of IPD per 100,000 person-years were as follows: 16 to 49 years: 7.2; 50 to 59 years: 29.4; 60 to 69 years: 69.1; and >=70 years: 207.1. The annual incidence of ACP per 100,000 person-years were as follows: 16 to 49 years: 438.8; 50 to 59 years: 809.6; 60 to 69 years: 1199.5; and >=70 years: 2770.9. The mean direct medical costs for IPD and ACP per episode were estimated to be €4551 and €993 respectively. The aggregate direct medical costs for IPD and ACP were estimated to be €28.5 million and €117.7 million respectively.

Conclusions

The clinical and economic burden of IPD and ACP among German adults is substantial regardless of age.

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HEALTH AND ECONOMIC IMPACT OF 15-VALENT PNEUMOCOCCAL CONJUGATE VACCINE (PCV15) SEROTYPES IN ADULTS 65 YEARS AND OLDER IN CANADA (ID 737)

Abstract

Background

The objective of this study is to quantify the epidemiologic and economic burden of pneumococcal disease attributable to 15-valent pneumococcal conjugate vaccine (PCV15) serotypes in Canada.

Methods

A published Markov model was adapted to estimate the burden of PCV15 serotypes in a cohort of unvaccinated Canadian adults aged 65 and older who were tracked from 2015 until death. The Markov model included the following health states: no pneumococcal disease, invasive pneumococcal diseases (IPD), non-bacteremic pneumococcal pneumonia (NBPP) and death. Economic burden was estimated from a publicly funded health care payer perspective, by multiplying the number of inpatient/outpatient visits by the cost per inpatient/outpatient visits.

Results

The model resulted in an estimated 7,834 cases of IPD and 110,372 cases of NBPP hospitalizations. Of these, there were 1,684 cases of IPD related deaths and 8,444 cases of NBPP related death. Total lifetime discounted healthcare costs attributable to PCV15 serotypes were estimated to be approximately $874.6 million. 38.5% of these costs ($337.1 million) were attributable to serotypes 22F and 33F and 22.2% were attributable to serotype 3.

Conclusions

The serotypes included in PCV15 contribute considerably to the health and economic burden of pneumococcal disease among older adults in Canada.

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Author Of 7 Presentations

HEALTH AND ECONOMIC IMPACT OF 15-VALENT PNEUMOCOCCAL CONJUGATE VACCINE (PCV15) SEROTYPES IN ADULTS 65 YEARS AND OLDER IN CANADA (ID 737)

Abstract

Background

The objective of this study is to quantify the epidemiologic and economic burden of pneumococcal disease attributable to 15-valent pneumococcal conjugate vaccine (PCV15) serotypes in Canada.

Methods

A published Markov model was adapted to estimate the burden of PCV15 serotypes in a cohort of unvaccinated Canadian adults aged 65 and older who were tracked from 2015 until death. The Markov model included the following health states: no pneumococcal disease, invasive pneumococcal diseases (IPD), non-bacteremic pneumococcal pneumonia (NBPP) and death. Economic burden was estimated from a publicly funded health care payer perspective, by multiplying the number of inpatient/outpatient visits by the cost per inpatient/outpatient visits.

Results

The model resulted in an estimated 7,834 cases of IPD and 110,372 cases of NBPP hospitalizations. Of these, there were 1,684 cases of IPD related deaths and 8,444 cases of NBPP related death. Total lifetime discounted healthcare costs attributable to PCV15 serotypes were estimated to be approximately $874.6 million. 38.5% of these costs ($337.1 million) were attributable to serotypes 22F and 33F and 22.2% were attributable to serotype 3.

Conclusions

The serotypes included in PCV15 contribute considerably to the health and economic burden of pneumococcal disease among older adults in Canada.

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HEALTH AND ECONOMIC IMPACT OF 15-VALENT PNEUMOCOCCAL CONJUGATE VACCINE (PCV15) SEROTYPES IN ADULTS 65 YEARS AND OLDER IN THE U.S. (ID 744)

Abstract

Background

This analysis quantifies the epidemiologic and economic burden of pneumococcal disease attributable to 15-valent pneumococcal conjugate vaccine (PCV15) serotypes in a hypothetical cohort of US adults aged 65 years and older in the US.

Methods

A Markov model was used to estimate pneumococcal disease cases, deaths and costs attributable to PCV15 serotypes. A cohort of unvaccinated adults aged ≥65 years from 2017 were tracked until death. Economic burden was estimated from a payer perspective, by multiplying the number of inpatient/outpatient visits by the cost per inpatient/outpatient visits. Costs were discounted at 3% per year.

Results

An estimated 74,956 cases of IPD; 10,336 cases of IPD related deaths; 2,286,581 cases of NBPP hospitalizations and 135,566 cases of NBPP related deaths were attributable to PCV15 serotypes in adults aged ≥65 years in the U.S. Total lifetime discounted healthcare costs attributable to PCV15 serotypes were estimated to be approximately $19.9 million. 36.3% of these cases, deaths and costs were attributable to serotypes 22F and 33F and 42.4% were attributable to serotype 3.

Conclusions

PCV15 serotypes contribute to substantial health and economic burden of pneumococcal disease among older adults (aged ≥65 years) in the U.S., majority of which is attributable to the serotypes 3, 22F, and 33F.

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INVASIVE PNEUMOCOCCAL DISEASE IN ADULTS IN TENNESSEE AND GEORGIA, USA: RESULTS FROM THE PNEUMO STUDY (ID 351)

Abstract

Background

Surveillance of invasive pneumococcal disease (IPD) is important to understand the effects of direct and indirect protection from pneumococcal vaccination programs and inform vaccine development and policy.

Methods

As part of the ongoing Pneumococcal Pneumonia Epidemiology, Urine Serotyping, and Mental Outcomes (PNEUMO) study, we enrolled adults hospitalized with IPD in Nashville and Atlanta from September-2018 to August-2019. IPD was defined by isolation of Streptococcus pneumoniae from a normally-sterile site.

Results

We enrolled 25 IPD cases, including 18 (72%) pneumonia, 5 (20%) bacteremia without an identified focus, 1 meningitis, and 1 septic arthritis. Pneumococcal serotype was identified from blood culture in 20 cases, including serotypes: 35B–(3 cases), 3-(2 cases), 15A-(2 cases), 19F-(2 cases), 20-(2 cases), 23A-(2 cases), 22F, 8, 9N, 11A, 23B, 31, 35F. Median age was 62 years; 23 (92%) presented from a community residence; 12 (48%) were immunocompromised; and all had ≥1 major chronic medical condition. In-hospital outcomes: 0 deaths; 10 (40%) ICU admissions; 9 (36%) mechanical ventilation; 3 (12%) vasopressors; 3 (12%) pleural drainage procedure; 1 (4%) new renal-replacement-therapy.

Conclusions

IPD is a highly morbid disease in US adults, with most cases in this study caused by serotypes not in the current 13-valent pneumococcal conjugate vaccine.

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CLINICAL AND ECONOMIC BURDEN OF PNEUMOCOCCAL DISEASE AMONG INDIVIDUALS AGED 16 YEARS AND OLDER IN GERMANY (ID 748)

Abstract

Background

The study assessed the incidence rate of all-cause pneumonia (ACP) and invasive pneumococcal disease (IPD) and associated direct medical costs among individuals aged 16 years and older in Germany.

Methods

ACP and IPD were identified using ICD-10-GM codes in the InGef database from 2014 to 2017. Incidence rate was expressed as the number of episodes per 100,000 person-years. Direct medical costs were estimated as the total cost of all inpatient and outpatient visits, divided by the total number of episodes.

Results

The annual incidence of IPD per 100,000 person-years were as follows: 16 to 49 years: 7.2; 50 to 59 years: 29.4; 60 to 69 years: 69.1; and >=70 years: 207.1. The annual incidence of ACP per 100,000 person-years were as follows: 16 to 49 years: 438.8; 50 to 59 years: 809.6; 60 to 69 years: 1199.5; and >=70 years: 2770.9. The mean direct medical costs for IPD and ACP per episode were estimated to be €4551 and €993 respectively. The aggregate direct medical costs for IPD and ACP were estimated to be €28.5 million and €117.7 million respectively.

Conclusions

The clinical and economic burden of IPD and ACP among German adults is substantial regardless of age.

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COGNITIVE FUNCTION FOLLOWING PNEUMOCOCCAL AND ALL-CAUSE PNEUMONIA: RESULTS FROM THE PNEUMO STUDY (ID 353)

Abstract

Background

Systemic inflammation from pneumonia may lead to acute brain dysfunction and long-term cognitive impairment, especially in older patients with severe pneumonia.

Methods

As part of the ongoing Pneumococcal Pneumonia Epidemiology, Urine Serotyping, and Mental Outcomes (PNEUMO) study, we prospectively enrolled adults hospitalized with community-acquired pneumonia. We tested for Streptococcus pneumoniae with cultures and BinaxNOW urinary antigen tests. We assessed global cognition in patients ≥50 years old with the Montreal Cognitive Assessment-Blind Adaptation (MoCA-Blind). MoCA-Blind scores range from 0 to 22 with higher scores indicating better cognition. Adults with a MoCA-Blind score <18 are considered to have cognitive impairment. We administered the MoCA-Blind instrument at enrollment when the patient was acutely ill and 6-months later by phone.

Results

At the time of this interim analysis, 150 patients had cognitive assessments completed at enrollment and 6-months, including 12 (8.0%) with pneumococcal pneumonia. Median (IQR) age was 64 (58-71) years. Cognitive impairment was common at both enrollment and 6-months later (Figure). At 6-month follow-up, 58% of pneumococcal and 52% of non-pneumococcal pneumonia patients had a MoCA-Blind score <18.

pneumo_boxplot_fig_11-30-2019.jpg

Conclusions

Hospitalization for pneumonia, including pneumococcal pneumonia, is associated with high risk of acute and persistent cognitive impairment among US adults ≥50 years old.

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