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Patients incur healthcare expenditures associated with RSV for months after the acute infection, underscoring the need for prevention through vaccination.

RSV-associated lower respiratory tract illness that requires ambulatory care or hospitalization incurs significant healthcare costs, with economic implications that last beyond the acute stage of the illness, according to findings published in Open Forum Infectious Diseases.

“While the economic burden of RSV among infants in the United States has been relatively well-documented in published literature, few studies have evaluated the economic burden of RSV among US adults,” Ahuva Averin, MPP, and colleagues wrote. “Because of the limited data on the attributable cost of RSV beyond the acute phase of illness among US adults, and because of the limited data on the economic burden of RSV among US adults by age, comorbidity profile, and care setting, a new study was undertaken.”

Averin and colleagues performed a retrospective observational matched-cohort study using data from a repository of healthcare claims filed in the United States between 2016 and 2019. The study included adults aged 18 and older who experienced RSV-associated lower respiratory tract illness (RSV-LRTI) requiring hospitalization, ED visits, or visits to a physician’s office or hospital outpatient unit, as well as a matched cohort of comparator patients.

Researchers determined all-cause healthcare costs during the acute phase, which was defined as either the period between admission and 30 days post-discharge for hospitalized patients, or the costs incurred during the episode for patients with ambulatory cases of RSV. Averin and colleagues also calculated healthcare costs during the longer term, defined as the end of the acute phase through the following 1-year period.

Acute & Long-Term Costs

The study population consisted of 4,526 matched pairs of patients with RSV-LRTI (RSV-LRTI requiring hospitalization: n=970; an ED visit: n=590; or a physician office/hospital outpatient visit: n=2,966) and comparator patients. The mean age of patients was 56 years, and nearly two-thirds (61%) were women.

In the acute illness period, patients who were hospitalized with RSV-LRTI incurred mean costs of $42,179 compared with just $5,154 for matched comparison patients, researchers reported.

For patients with RSV-LRTI who visited the ED, the mean healthcare costs were $4,409 compared with $377 for matched controls. For those who visited physicians’ offices or outpatient hospital centers, the mean cost was $922, compared with $201 for matched comparators.

By the time the year-long follow-up period was over, average healthcare expenditures ballooned, according to Averin and colleagues. Between the acute and long-term phases, those who were hospitalized for RSV-LRTI had a mean healthcare expenditure of $101,532 compared with $36,302 for matched controls, whereas those who visited an ED had a mean of $48,701 versus $27,131 for comparator patients. Patients who visited a physician’s office or outpatient hospital clinic had $28,851 in expenditures compared with $20,523 for matched controls.

Averin and colleagues also noted that patients with comorbidities experienced higher incurred costs across all healthcare settings. The most common comorbidity profiles included chronic cardiovascular, chronic metabolic, and chronic pulmonary.

RSV Prevention to Reduce Costs

Overall, the total cost attributable to hospitalization for RSV-LRTI was $65,230, whereas emergency room visits had a total cost of $21,570, and physician’s office or outpatient visits totaled $8,327.

Researchers acknowledged that the study was limited by its reliance on healthcare database information. Further, they note that the study may have misestimated costs because it did not account for all patients with RSV-LRTI. It also used expenditures to measure the economic impact of the illness­­—namely, monetary amounts paid by patients and health insurance providers—rather than “the true cost of healthcare,” which may have produced a downward bias in cost estimates.

However, they note that the study is the first to describe costs associated with RSV-LRTI by care type in the acute and long-term phases among US adults.

“The cost of RSV-LRTI requiring hospitalization or ambulatory care among US adults is substantial, and the economic impact of RSV-LTRI may extend well beyond the acute phase of illness,” Averin and colleagues wrote. “Strategies to prevent RSV-LRTI among adults—including the recent recommendation for RSV vaccination among US adults aged [60 and older]—have the potential to yield considerable economic benefits to the US healthcare system.”

Key Takeaways

• Average healthcare expenditures for RSV-related lower respiratory tract illness (RSV-LRTI) go far beyond the initial infection
• Patients with RSV who were hospitalized had the highest expenditures in both the acute and long-term phases of the study
• Strategies to prevent RSV-LRTI among adults, including vaccination, could yield considerable economic benefits for the healthcare system