Abstract
Respiratory syncytial virus (RSV) is the most common cause of pediatric acute lower respiratory tract infection worldwide. Detailed data on the health and economic burden of RSV disease are lacking from tropical settings with year-round RSV transmission. We developed a statistical and economic model to estimate the annual incidence and healthcare cost of medically attended RSV disease among young children in Singapore, using Monte Carlo simulation to account for uncertainty in model parameters. RSV accounted for 708 hospitalizations in children <6 months of age (33.5/1,000 child-years) and 1,096 in children 6–29 months of age (13.2/1,000 child-years). The cost of hospitalization was SGD 5.7 million (US $4.3 million) at 2014 prices; patients bore 60% of the cost. RSV-associated disease burden in tropical settings in Asia is high and comparable to other settings. Further work incorporating efficacy data from ongoing vaccine trials will help to determine the potential cost-effectiveness of different vaccination strategies.
Highlights
Respiratory syncytial virus (RSV) is the most common cause of pediatric acute lower respiratory tract infection worldwide
All children admitted to KKH with respiratory symptoms, regardless of clinical severity, are tested by nasopharyngeal swab sampling for a panel of respiratory viruses using direct immunofluorescence antibody (DFA)
We developed 2 cost models: the full-cost model estimated the total cost of RSV-related healthcare, whereas the subsidized cost estimated the share of healthcare costs paid by patients after accounting for public subsidies
Summary
Respiratory syncytial virus (RSV) is the most common cause of pediatric acute lower respiratory tract infection worldwide. Detailed data on the health and economic burden of RSV disease are lacking from tropical settings with year-round RSV transmission. We developed a statistical and economic model to estimate the annual incidence and healthcare cost of medically attended RSV disease among young children in Singapore, using Monte Carlo simulation to account for uncertainty in model parameters. Further work incorporating efficacy data from ongoing vaccine trials will help to determine the potential cost-effectiveness of different vaccination strategies. Potential immunization strategies include vaccination of children, pregnant mothers, and older adults. Assessing the potential impact and cost-effectiveness of future vaccination strategies relies on robust estimates of RSV-related health burden and cost, to inform national procurement and prioritization decisions. We present estimates of RSV-related primary care consultations, hospitalizations, and associated healthcare costs among children
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