Evaluating the Individual Healthcare Costs and Burden of Disease Associated with RSV Across Age Groups

Abstract

Background Respiratory syncytial virus (RSV) is a major cause of acute respiratory infection (ARI), with high morbidity and mortality worldwide. RSV costing and burden estimates can highlight the potential benefits of future vaccination programs and are essential for economic evaluations. Objective We aimed to determine RSV healthcare costs across age groups and the overall disease burden of medically attended RSV in Canada. Methods We conducted a retrospective case–control study to estimate the attributable healthcare costs per RSV case in Alberta. We used two case definitions to capture diversity in case severity: laboratory-confirmed RSV and ARI attributable to RSV. Matching occurred on five criteria: (1) age, (2) urban/rural status, (3) sex, (4) prematurity and (5) Charlson Comorbidity Index score. We calculated the age-specific burden of medically attended RSV in Canada from 2010 to 2019 by multiplying the weekly age-specific incidence of medically attended ARI with the RSV positivity rate. Results Costs per laboratory-confirmed RSV case were (in Canadian dollars [CAD], year 2020 values) $CAD12,713 and 40,028 in the first 30 and 365 days following diagnosis, respectively, whereas a case of ARI potentially attributable to RSV cost $CAD316 and 915, in 30 and 365 days, respectively. Older (aged ≥ 65 years) and younger (aged < 90 days) age groups had the highest case costs. The average medically attended RSV incidence rate across nine seasons was 1743 cases per 100,000 people per year. Conclusions RSV is a common and expensive infection at the extremes of life, and the development of immunization programs targeting older and younger ages may be important for the reduction of RSV burden and cost. Supplementary Information The online version contains supplementary material available at 10.1007/s40273-022-01142-w.

Estimation of the number of RSV-associated hospitalisations in adults in the European Union

“…Among adults aged ≥65 years in the US, about 159 000 RSV-associated hospitalisations are estimated to occur each year which is comparable to our estimates of over 145 000 hospitalisations occurring in the same age group across the EU [34]. We have focused on RSV-associated hospital admission in older adults which is considered more severe, expensive and has quality of life implications [35], but recognise that there is also a significant amount of RSV disease burden in the outpatient setting [36].…”

Cost-Effectiveness Analysis of Nirsevimab and RSVpreF Vaccine Prevention Strategies for Respiratory Syncytial Virus Disease in infants: A Canadian Immunisation Research Network (CIRN) Study

“…The annual incidence of medically-attended (MA) RSV cases per 100,000 population was sampled from the range 1001 – 2439, and distributed among infants under one year of age according to estimated rates and seasonality distribution ( Supplementary Material, Figure A1, Table A2 ). 7 In our study, MA RSV refers to outpatient care (i.e., office visit or emergency department (ED) visit without hospital admission) or inpatient care (i.e., hospital admission in paediatric ward or intensive care unit, ICU). We considered the beginning of October as the start of RSV season recognizing that the RSV season varies geographically and temporally ( Supplementary Material, Figure A3 ).…”

“…We considered the beginning of October as the start of RSV season recognizing that the RSV season varies geographically and temporally (Supplementary Material, Figure A3). 7,19 We allowed for a maximum of two MA RSV events during the first year of life, 20 with a minimum time-interval of three months between the two events if the second episode occurred. The duration of symptomatic RSV disease for those receiving outpatient care was sampled between 5 to 8 days.…”

“…1 The direct (e.g., outpatient and inpatient care) and indirect (e.g., loss of productivity, parental costs, and psychological health) costs of RSV disease among infants are substantial. [4][5][6][7] In the absence of a preventive vaccine, efforts to curb the burden of RSV among infants in the last two decades have relied on passive immunisation with the anti-RSV monoclonal antibody palivizumab. Palivizumab is currently administered in five monthly doses to infants at high-risk of severe RSV disease during the local RSV epidemic season.…”

“…1 The direct (e.g., outpatient and inpatient care) and indirect (e.g., loss of productivity, parental costs, and psychological health) costs of RSV disease among infants are substantial. 4–7…”