Saturday, July 13, 2024

Comprehensive Economic Analysis of RSV Lower Respiratory Infections Highlights Significant Healthcare Burden

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The economic implications of respiratory syncytial virus (RSV) lower respiratory infections (LRI) in children are immense, influencing the evaluation of new immunoprophylaxes. This study delves into the cost differences between entire episodes of RSV illness and individual encounters, revealing the substantial financial burden on the healthcare system, especially for high-risk groups.

Data and Methodology

Researchers utilized MarketScan® data from 2015 to 2019 to form cohorts of children under five years old, categorized by age and condition. The investigation compared the aggregated healthcare costs of RSV-LRTI episodes with costs calculated from RSV-specific encounters alone. By multiplying costs per encounter or episode by their respective incidence rates, the economic burden was estimated.

Key Findings

The analysis revealed that the average cost per episode was significantly higher than per encounter, regardless of the healthcare setting. For infants, inpatient costs per episode were $28,586 compared to $18,056 per encounter, while outpatient/ED costs were $2099 per episode versus $407 per encounter. Across all age groups, the economic burden was most significant for infants and those requiring inpatient care. However, due to higher incidence rates, the burden in outpatient/ED settings was disproportionately high.

Specifically, for high-risk children, the economic costs and burden could be three to ten times greater, spotlighting the critical need for effective market access strategies for new RSV immunoprophylaxes. This data underscores the importance of including comprehensive treatment episodes in economic evaluations to ensure accurate cost assessment and resource allocation.

Inference Section

Concrete implications based on the findings include:

  • Inpatient care for infants with RSV-LRTI incurs the highest costs, necessitating targeted funding and strategic planning for healthcare providers.
  • Outpatient/ED settings, despite lower per-episode costs, contribute significantly to the overall economic burden due to high incidence rates, indicating a need for broader access to preventative measures.
  • High-risk groups face exponentially higher costs, highlighting the necessity for early and extensive access to RSV immunoprophylaxes.

The research provides a critical framework for policymakers to assess the economic value of new RSV immunoprophylaxes, emphasizing the need for inclusive and stratified economic evaluations. By considering both encounter- and episode-based estimates, a robust understanding of the financial landscape can be achieved, informing better healthcare policies and market access strategies.

Original Article:

Influenza Other Respir Viruses. 2024 Jul;18(7):e13347. doi: 10.1111/irv.13347.


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BACKGROUND: The cost of medically attended RSV LRI (lower respiratory infection) is critical in determining the economic value of new RSV immunoprophylaxes. However, most studies have focused on intermittent RSV encounters, not the episode of care that captures the entirety of RSV illness.

METHODS: We created age- and condition-specific cohorts of children under 5 years of age using MarketScan® data (2015-2019). We contrasted aggregating healthcare costs over RSV-LRTI episodes to ascertaining costs based on RSV-specific encounters only. Economic burden was estimated by multiplying costs per encounter or per episode by their respective incidence rates.

RESULTS: Average cost was higher per episode than per encounter regardless of settings (inpatient: $28,586 vs. $18,056 and outpatient/ED: $2099 vs. $407 for infants). Across ages, the economic burden was highest for infants and RSV-LRTI requiring inpatient care, but the burden in outpatient/ED settings was disproportionately higher than costs due to higher incidence rates (for inpatient vs. outpatient episodes: $226,403 vs. $101,269; for inpatient vs. outpatient encounters: $151,878 vs. $38,819 per 1000 infant-years). For high-risk children, cost and burden were up to 3-10 times higher, respectively.

CONCLUSIONS: With a comprehensive stratification by settings and risk condition, the encounter- versus episode-based estimates provide a robust range for policymakers’ economic appraisal of new RSV immunoprophylaxes.

PMID:38951044 | DOI:10.1111/irv.13347

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