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. 2024 Aug 16;230(2):e342-e352.
doi: 10.1093/infdis/jiad559.

The Annual Economic Burden of Respiratory Syncytial Virus in Adults in the United States

Justin Carrico  1 , Katherine A Hicks  1 , Eleanor Wilson  2 , Catherine A Panozzo  2 , Parinaz Ghaswalla  2
Affiliations

The Annual Economic Burden of Respiratory Syncytial Virus in Adults in the United States

Justin Carrico et al. J Infect Dis. .

Abstract

Background: Current estimates of the economic burden of respiratory syncytial virus (RSV) are needed for policymakers to evaluate adult RSV vaccination strategies.

Methods: A cost-of-illness model was developed to estimate the annual societal burden of RSV in US adults aged ≥60 years. Additional analyses were conducted to estimate the burden of hospitalized RSV in all adults aged 50-59 years and in adults aged 18-49 years with potential RSV risk factors.

Results: Among US adults aged ≥60 years, the model estimated 4.0 million annual RSV cases (95% uncertainty interval [UI], 2.7-5.6 million) and an annual economic burden of $6.6 billion (95% UI, $3.1-$12.9 billion; direct medical costs, $2.9 billion; indirect costs, $3.7 billion). The 4% of RSV cases that were hospitalized contributed to 94% of direct medical costs. Additional analyses estimated $422 million in annual hospitalization costs among all adults aged 50-59 years. Among adults aged 18-49 years with RSV risk factors, annual per capita burden was highest among people with congestive heart failure at $51 100 per 1000 people.

Discussion: The economic burden of RSV is substantial among adults aged ≥50 years and among adults aged 18-49 years with RSV risk factors, underscoring the need for preventive interventions for these populations.

Keywords: adults; burden of disease; cost of illness; high-risk adults; respiratory syncytial virus.

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Conflict of interest statement

Potential conflicts of interest. E. W., C. A. P., and P. G. are employees of Moderna, Inc, and hold stock/stock options in the company. J. C. and K. A. H. are employees at RTI Health Solutions and were contracted by Moderna, Inc to conduct this study.

Figures

Figure 1.
Figure 1.
Model diagram. A, The number of RSV cases treated in outpatient, ED, and hospital settings were calculated from data on the distribution of health care resource use from RSV cases; the remaining cases were assumed to not be medically attended. RSV-related deaths occurring during hospitalized cases were also accounted for. B, The model's decision tree structure for additional analyses of the burden of hospitalized RSV in adults aged 50–59 years and adults aged 18–49 years with potential RSV risk factors. Nonhospitalized RSV cases were not considered in these age groups due to limited data availability. Abbreviations: ED, emergency department; RSV, respiratory syncytial virus.
Figure 2.
Figure 2.
Estimates of health and economic burden of RSV in US adults aged ≥60 years. A, morbidity and mortality. B, Societal economic burden, inclusive of direct medical costs and indirect medical costs. Abbreviations: ED, emergency department; M, million; RSV, respiratory syncytial virus.
Figure 3.
Figure 3.
One-way sensitivity analysis results for RSV economic burden in adults aged ≥60 years. The analysis displays model parameters with the largest influence on the annual societal economic burden of RSV. Values in parentheses report the range of values considered in the one-way sensitivity analysis. Abbreviations: ED, emergency department; M, million; RSV, respiratory syncytial virus.
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