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. 2025 May;30(20):2400797.
doi: 10.2807/1560-7917.ES.2025.30.20.2400797.

Economic impact of RSV infections in young children attending primary care: a prospective cohort study in five European countries, 2021 to 2023

Valérie Dv Sankatsing  1 , Sarah F Hak  2 , Joanne G Wildenbeest  2 , Roderick P Venekamp  3 , Mauro Pistello  4 , Caterina Rizzo  4 , Santiago Alfayate-Miguélez  5 , Daan Van Brusselen  6   7 , Marta Carballal-Mariño  8 , Uy Hoang  9 , Rolf Kramer  10 , Simon de Lusignan  9 , Oliver Martyn  10 , Marc Raes  11 , Adam Meijer  12 ; RSV ComNet Network  13 ; Jojanneke van Summeren  1
Affiliations

Economic impact of RSV infections in young children attending primary care: a prospective cohort study in five European countries, 2021 to 2023

Valérie Dv Sankatsing et al. Euro Surveill. 2025 May.

Abstract

BackgroundData on economic costs of respiratory syncytial virus (RSV) infections among children in primary care are scarce, although most RSV-infections are managed in this setting.AimTo estimate outpatient costs for RSV-positive children aged < 5 years.MethodsIn the RSV ComNet prospective cohort, children < 5 years with acute respiratory infection were recruited for RSV testing through primary care physicians in Belgium, Italy, the Netherlands, Spain and the United Kingdom (UK) during RSV seasons 2020/21 (UK only), 2021/22 and 2022/23. Outpatient healthcare utilisation and parental work absence were assessed over 30 days through parental questionnaires. Average costs per RSV episode were calculated from outpatient healthcare sector and societal perspectives, stratified by country and age.ResultsWe included 3,414 children and 1,124 (33%) tested RSV-positive. Physicians completed reports for 878 episodes, with follow-up questionnaire data for 819 (93%). Outpatient costs ranged from EUR 97 (95% CI: 91-104) in the Netherlands to EUR 300 (95% CI: 287-312) in Spain and were higher for infants than children aged 1-5 years. Societal costs ranged from EUR 454 (95% CI: 418-494) in the UK to EUR 994 (95% CI: 938-1,053) in Belgium. For children aged 1-5 years, societal costs were primarily driven by parental work absence. In infants, the main societal cost driver varied by country, but overall outpatient healthcare costs represented a higher proportion of societal costs vs older children.ConclusionRSV infections in children attending primary care result in substantial economic costs per episode, although differences exist across countries. This study provides essential data to inform cost-effectiveness analyses on novel RSV immunisations.

Keywords: RSV; costs; outpatient; parental work absence; primary care; respiratory syncytial virus.

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Conflict of interest statement

Conflict of interest: JvS and VS declare that Nivel has received unrestricted research grants from WHO, Sanofi, AstraZeneca and the Foundation for Influenza Epidemiology. JW and AM receive a grant from the Respiratory Syncytial Virus Consortium in Europe (RESCEU) project of the ‘Innovative Medicines Initiative 2 Joint Undertaking’ grant agreement No 116019. This Joint Undertaking gets support from the ‘European Union's Horizon 2020 research and innovation programme’ and the ‘European Federation of Pharmaceutical Industries and Associations’. JvS, JW, and AM receive a grant from the Preparing for RSV Immunisation and Surveillance in Europe (PROMISE) project of the ‘Innovative Medicines Initiative 2 Joint Undertaking’ grant agreement No 101034339. This Joint Undertaking gets support from the ‘European Union's Horizon 2020 research and innovation programme’ and the ‘European Federation of Pharmaceutical Industries and Associations’. JW has been an investigator for clinical trials sponsored by pharmaceutical companies including AstraZeneca, Merck, Pfizer, Sanofi, and Janssen. All funds have been paid to UMCU. JW participated in advisory boards of Janssen and Sanofi and was a speaker at Sanofi and MSD sponsored symposia with fees paid to UMCU. CR declares that she received fees for participation in advisory boards; for lectures, presentations, speakers’ bureaus, manuscript writing or educational events; and for attending meetings/travelling from: AstraZeneca, Seqirus, MSD, Sanofi and GSK and for CME lectures from Seqirus, Sanofi, AstraZeneca, MSD and GSK. CR is a member of the Italian NITAG. MGS has received honoraria from GSK group of companies, Pfizer Inc, Sanofi, MSD for taking part in advisory boards and expert meetings and for acting as a speaker in congresses outside the scope of the submitted work. MCM is Coordinator (unpaid) of the Primary Care Pediatrics Research Network of the Spanish Association of Primary Care Pediatrics, PAPenRed, and has received a research grant from Nivel and for attending meetings from MSD. DVB has received honoraria from Pfizer and Sanofi for taking part in advisory boards and expert meetings and for acting as a speaker in congresses outside the scope of the submitted work. MR has received honoraria from Sanofi, MSD and GSK for taking part in advisory boards and expert meetings and for acting as a speaker in congresses outside of the scope of the submitted work. MR is President (unpaid) of the Belgian Society of Pediatrics and Board member (unpaid) of the Belgium Academy of Paediatrics. SdeL and UH are receiving funding from Roche to evaluate their Cobas Liat point of care testing platform for respiratory viruses in the UK. SdeL reports that through his University he has had grants not directly relating to this work, from AstraZeneca, GSK, Moderna, Sanofi, Seqirus and Takeda for vaccine related research and membership of advisory boards for AstraZeneca, GSK, Sanofi and Seqirus. SdeL is Director of the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (the UK’s sentinel network). SdeL is Provost of the South West Thames Faculty RCGP and deputy National RCGP Council representative. UH has undertaken continuing professional development podcasts funded by Seqirus and has been members of advisory boards for Jansen. OM and RK are employees of Sanofi and may hold shares and/or stock options in the company. RPV, SH, MCM, SAM, and MP have nothing to declare.

Figures

Figure 1
Figure 1
Flowchart of RSV-positive study participants included in the cost analysis, five European countries, 2020/21–2022/23 seasons (n = 819)
Figure 2
Figure 2
Societal costs in euro per RSV episode in children < 5 years attending primary care, five European countries, 2020/21–2022/23 seasons (n = 819)
See this image and copyright information in PMC

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