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. 2022 May;16(3):376-385.
doi: 10.1111/irv.12963. Epub 2022 Feb 5.

The economic burden of influenza among adults aged 18 to 64: A systematic literature review

Caroline de Courville  1 , Sarah M Cadarette  2 , Erika Wissinger  2 , Fabián P Alvarez  1
Affiliations

The economic burden of influenza among adults aged 18 to 64: A systematic literature review

Caroline de Courville et al. Influenza Other Respir Viruses. 2022 May.

Abstract

While the economic burden of influenza infection is well described among adults aged 65 and older, less is known about younger adults. A systematic literature review was conducted to describe the economic burden of seasonal influenza in adults aged 18 to 64 years, to identify the main determinants of direct and indirect costs, and to highlight any gaps in the existing published evidence. MEDLINE and Embase were searched from 2007 to February 7, 2020, for studies reporting primary influenza-related cost data (direct or indirect) or absenteeism data. Of the 2613 publications screened, 51 studies were included in this review. Half of them were conducted in the United States, and 71% of them described patients with influenza-like illness rather than laboratory-confirmed disease. Only 12 studies reported cost data specifically for at-risk populations. Extracted data highlighted that within the 18- to 64-year-old group, up to 88% of the economic burden of influenza was attributable to indirect costs, and up to 75% of overall direct costs were attributable to hospitalizations. Furthermore, within the 18- to 64-year-old group, influenza-related costs increased with age and underlying medical conditions. The reported cost of influenza-related hospitalizations was found to be up to 2.5 times higher among at-risk populations compared with not-at-risk populations. This review documents the considerable economic impact of influenza among adults aged 18 to 64. In this age group, most of the influenza costs are indirect, which are generally not recognized by decision makers. Future studies should focus on at-risk subgroups, lab-confirmed cases, and European countries.

Keywords: adult; cost of illness; human; influenza; working adults.

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Figures

FIGURE 1
FIGURE 1
PRISMA diagram showing flow of literature
FIGURE 2
FIGURE 2
Characteristics of included studies. Abbreviations: EU4, European Union 4; HCW, healthcare worker; ICD, International Classification of Diseases; ILI, influenza‐like illness; LCI, laboratory‐confirmed influenza; NR, not reported; PCR, polymerase chain reaction; RCT, randomized controlled trial; UK, United Kingdom; US, United States
See this image and copyright information in PMC

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