Abstract
BackgroundDespite several studies that have estimated the economic impact of Respiratory Syncytial Virus (RSV) in infants, limited data are available on healthcare resource use and costs attributable to RSV across age groups. The aim of this study was to quantify age-specific RSV-related healthcare resource use and costs on the US healthcare system.MethodsThis retrospective case-control study identified patients aged ≥1 year with an RSV event in the Truven Health Marketscan® Commercial Claims and Encounters and Medicare Supplemental and Coordination of Benefits databases between August 31, 2012 and August 1, 2013. RSV patients were matched 1:1 with non-RSV controls for age, gender, region, healthcare plan and index date (n = 11,432 in each group). Stratified analyses for healthcare resource use and costs were conducted by age groups. RSV-attributable resource use and costs were assessed based on the incremental differences between RSV cases and controls using multivariate analysis.ResultsRSV patients had a higher healthcare resource use (hospital stays, emergency room/urgent care visits, ambulatory visits and outpatient visits) than non-RSV matched controls for all age groups (all p < 0.0001), particularly in the elderly age groups with RSV (1.9 to 3 days length of stay, 0.4 to 0.5 more ER/UC visits, 0.7 to 2.7 more ambulatory visits, 12.1 to 18.6 more outpatient visits and 9.5 to 14.6 more prescriptions than elderly in the control groups). The incremental difference in adjusted mean annual costs between RSV and non-RSV controls was higher in elderly (≥65; $12,030 to $23,194) than in those aged < 65 years ($2251 to $5391). Among children, adjusted costs attributable to RSV were higher in children aged 5–17 years ($3192), than those 1–4 years ($2251 to $2521).ConclusionsOur findings showed a substantial annual RSV-attributable healthcare resource use and costs in the US across age groups, with the highest burden in those aged ≥65 years. These data can be used in cost-effectiveness analyses, and may be useful for policymakers to guide future RSV vaccination and other prevention programs.
Highlights
Despite several studies that have estimated the economic impact of Respiratory Syncytial Virus (RSV) in infants, limited data are available on healthcare resource use and costs attributable to RSV across age groups
Patient characteristics Of 63,702,072 individuals enrolled in the databases between August 31, 2012 and August 1, 2013, a total of 11,432 patients with RSV met the inclusion criteria and were matched 1:1 with controls without RSV (Fig. 1)
The prevalence of high-risk conditions increased with age, with those aged over 65 years being most commonly affected by comorbidities such as chronic pulmonary, cardiac and renal diseases, and diabetes mellitus (Fig. 2)
Summary
Despite several studies that have estimated the economic impact of Respiratory Syncytial Virus (RSV) in infants, limited data are available on healthcare resource use and costs attributable to RSV across age groups. [1,2,3,4,5] Globally, it was estimated in 2015, in children < 5 years of age there were 33.1 million episodes of lower respiratory tract infection due to RSV, with 3.2 million RSV-related hospitalizations and 59,600 inhospital deaths. The currently available evidence for RSV-attributable costs is limited by a lack of a control group in many of the studies, and so the impact of RSV on healthcare burden is not clearly defined. Many of these studies in the US focus on infants alone [7, 16,17,18,19,20,21,22,23,24] and little is known of the impact of RSV for those who are older, such as young children aged between 1 and 4 years and the elderly. [2, 25]
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