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Published on: July 27, 2021
Economic-Burden Trajectories in Commercially Insured US Infants With Respiratory Syncytial Virus Infection
Viktor V Chirikov1, Eric A F Simões2,3,4, Andreas Kuznik5
1Real World Evidence, Pharmerit International, Bethesda, Maryland.
Insights
The long-term respiratory syncytial virus (RSV) burden is significant for infants, especially premature infants, impacting healthcare costs for up to five years. This study highlights the economic impact of RSV across different infant groups.
Area of Science:
- Pediatric Health Economics
- Infectious Disease Epidemiology
- Neonatal Care
Background:
- Respiratory Syncytial Virus (RSV) poses a significant health risk to infants.
- Understanding the long-term economic burden of RSV is crucial for resource allocation and healthcare planning.
- Preterm infants are known to be at higher risk for severe RSV outcomes.
Purpose of the Study:
- To evaluate the long-term economic burden of Respiratory Syncytial Virus (RSV) in preterm and full-term infants in the United States.
- To compare the cumulative healthcare costs associated with RSV infection across different prematurity levels.
- To inform the cost-effectiveness analysis of developing RSV interventions.
Main Methods:
- Retrospective analysis of U.S. infants from the Truven MarketScan database (2004-2015).
- Inclusion criteria: birth hospitalization claims and ≥24 months continuous enrollment.
- RSV-infected infants (n=38,473) were matched to controls (n=76,825) using propensity score methods to analyze 5-year cumulative costs (all-cause, respiratory, asthma/wheezing).
Main Results:
- RSV infection significantly increased 5-year cumulative costs across all infant groups compared to controls.
- Early premature infants experienced the highest cost increase ($39,490), followed by premature ($23,160), late premature ($13,755), and full-term infants ($6,631).
- The greatest economic burden was observed within the second year post-RSV diagnosis, with higher costs in inpatient/outpatient and respiratory-related categories.
Conclusions:
- The economic burden of RSV is substantial and extends across various cost domains and prematurity levels.
- The impact of RSV on healthcare costs is most pronounced in the early years following diagnosis, particularly for premature infants.
- These findings provide valuable data for assessing the economic viability of novel RSV therapies currently in development.
Background:
This study evaluates the long-term respiratory syncytial virus (RSV) burden among preterm and full-term infants in the United States.
Methods:
Infants with birth hospitalization claims and ≥24 months of continuous enrollment were retrospectively identified in the Truven MarketScan Commercial Claims and Encounters database for the period 1 January 2004-30 September 2015. Infants with RSV infection in the first year of life (n = 38 473) were matched to controls (n = 76 825), and remaining imbalances in the number of individuals in each group were adjusted using propensity score methods. All-cause, respiratory-related, and asthma/wheezing-related 5-year average cumulative costs were measured.
Results:
Early premature (n = 213), premature (n = 397), late premature (n = 4446), and full-term (n = 33 417) RSV-infected infants were matched to 424, 791, 8875, and 66 735 controls, respectively. After 2 years since RSV diagnosis, all-cause cumulative costs for RSV-infected infants as compared to those for controls increased by $22 081 (95% confidence interval [CI], -$5800-$42 543) for early premature infants, by $14 034 (95% CI, $5095- $22 973) for premature infants, by $10 164 (95% CI, $8835-$11 493) for late premature infants, and by $5404 (95% CI, $5110-$5698) for full-term infants. The 5-year RSV burden increased to $39 490 (95% CI, $18 217-$60 764), $23 160 (95% CI, $13 002-$33 317),$13 755 (95% CI, $12 097-$15 414), and $6631 (95% CI, $6060-$7202), respectively. The RSV burden was higher when stratified by inpatient and outpatient setting and respiratory-related and asthma/wheezing-related costs.
Conclusions:
The RSV burden extends across cost domains and prematurity, with the greatest burden incurred by the second year of follow-up. Findings are useful in determining the cost-effectiveness of RSV therapies in development.
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