Assessing the Economic Burden of RSV-Associated Hospitalizations Among US Adults

Respiratory syncytial virus (RSV) makes up a significant economic burden of cardiorespiratory hospitalizations, in which vaccine utilization and uptake may help alleviate these costs, a study suggests.¹

The cohort study is published in Human Vaccines & Immunotherapeutics.

In this study, the researchers aimed to estimate the annual economic burden of RSV infection on cardiorespiratory hospitalizations among insured US adults to better understand the impact of RSV | Image credit: Peter Hansen - stock.adobe.com

“The results of this study can provide vaccine policy decision-makers and payers with a more complete understanding of the economic burden of RSV infections on cardiorespiratory hospitalizations among adults,” wrote the researchers of the study. “This is particularly important to consider for those at high risk for severe RSV in an analysis of national-level data.”

Older adults and infants are most at risk for both hospitalizations and morbidity due to RSV.² Despite vaccine hesitancy surrounding vaccination, especially for infants, previous research supports increased awareness of the diseases to reduce vaccine hesitancy and improve trust in health care providers.³

In this study, the researchers aimed to estimate the annual economic burden of RSV infection on cardiorespiratory hospitalizations among insured US adults to better understand the impact of RSV.¹

The study included insured US adults 18 years and older in the Merative MarketScan claims database from September through August of 2017-2018 and 2018-2019. The number of RSV-associated cardiorespiratory hospitalizations were identified using International Classification of Diseases (ICD) diagnosis codes in the presence or absence of RSV circulation per weekly laboratory test positivity percentages from the CDC.

Additionally, the researchers aimed to describe health care resource utilization (HCRU) characteristics of ICD-coded RSV hospitalizations among this patient population.

Of the total 22,617,080 patients across all payer types, 19,794,099 patients met the cohort criteria for the study period. Of these patients, 18,515,878 had commercial/Medicare supplemental enrollment in 2017-2018, and 16,462,120 had commercial/Medicare supplemental enrollment in 2018-2019.

Among those with commercial/Medicare, the mean (SD) age was 44.25 (15.93) years in 2017-2018, and 44.02 (15.50) years in 2018-2019. Additionally, the high-risk subgroup accounted for 13.5% and 16.1% of commercial/Medicare adults overall in 2017-2018 and 2018-2019, respectively. High-risk adults were older and more likely to be enrolled in Medicare supplemental benefits, have comorbidities, be immunocompromised, and be frail.

In 2017-2018, 301,248 cardiorespiratory hospitalizations were identified, in which 0.32% had RSV-specific ICD codes, costing $44,916,324. Of these hospitalizations, 5.52% were RSV associated, costing $734,078,602 (95% CI, $460,826,580-$1,103,358,799).

In 2018-2019, 215,525 cardiorespiratory hospitalizations were observed, in which 0.34% had RSV-specific codes, costing $33,053,105, and 3.14% were RSV-associated cardiorespiratory hospitalizations, costing $287,549,472 (95% CI, $173,377,778-$421,884,259).

The researchers acknowledged the study had some limitations. Regarding significant regional differences in the seasonality of RSV circulation, MarketScan data only included geographic region for individuals enrolled in commercial or Medicare supplemental health benefits. Additionally, the RSV laboratory positivity dataset from the CDC was not available at state or regional levels. Therefore, the study outcomes were not able to be stratified by geographic region for Medicaid beneficiaries.

Further limitations include possible insurance coverage bias, CDC data limitations, administrative claims data constraints, and estimation methodology since there is no gold standard for estimating RSV-associated events.

Despite these limitations, the researchers believe the study found that RSV infection contributes to a substantial clinical and economic burden of cardiorespiratory hospitalizations.

“Future research using similar methods in other data sources and study populations, such as high-risk patients, should be conducted to contextualize findings from our study,” wrote the researchers.

References

1. Patel DA, Marcum ZA, Chansakul A, et al. Economic burden of cardiorespiratory hospitalizations associated with respiratory syncytial virus among United States adults in 2017–2019. Human Vaccines Immunother. 2024;20(1):2364493. doi:10.1080/21645515.2024.2364493

2. Bonavitacola J. Study finds mortality, hospitalizations due to RSV highest in infants, older adults. The American Journal of Managed Care^®. July 11, 2023. Accessed July 31, 2024. https://www.ajmc.com/view/study-finds-mortality-hospitalizations-due-to-rsv-highest-in-infants-older-adults

3. Steinzor P. Why are some parents still hesitant to vaccinate their child against RSV? AJMC^®. June 26, 2024. Accessed July 31, 2024. https://www.ajmc.com/view/why-are-some-parents-still-hesitant-to-vaccinate-their-child-against-rsv-