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.

Fig. 1

Equation for age-specific weekly incidence rate of respiratory syncytial virus in Alberta, Canada

Fig. 2

Laboratory-confirmed RSV and ARI attributed to RSV case, control and attributable costs within 30 and 365 days of diagnosis. ARI acute respiratory infection, RSV respiratory syncytial virus

Fig. 3

Attributable costs over 30 days presented by age group and care type for laboratory-confirmed RSV and ARI attributed to RSV care types are divided into MD (physician billing claims for both outpatient and inpatient), Amb (ambulatory care, such as emergency department visits) and Inp (inpatient costs excluding physician costs). ARI acute respiratory infection, RSV respiratory syncytial virus

Fig. 4

Total medically attended respiratory syncytial virus (RSV) infection rate in Alberta from 2010 to 2019