Shedding Light into the Dark of Unknown Cost-of-Illness and Burden-of-Disease Associated with RSV across Age Groups in Austria

OBJECTIVES: Respiratory syncytial virus related acute respiratory infection (RSV-ARI) constitutes a substantial disease burden in infants, children, and older adults. In infants, it is the most common single cause of respiratory hospitalization. In adults, RSV is an under-recognized cause of deterioration in health, particularly among frail elderly persons. Infection rates typically rise in late autumn and early winter. Little has been published on RSV-related costs for Europe and thus the cost-of-illness (COI) is unknown. Accurate knowledge about COI is essential to formulate/prioritize health-care policies and interventions. The aim is therefore to ascertain the direct and indirect costs associated with RSV-ARI for Austria.

METHODS: The analysis was conducted in two steps. First a comprehensive systematic literature review was undertaken. Second, a probability pathway model was developed based on defined patient populations stratified by age and risk to estimate the direct and indirect costs. Costs (2023€) are determined bottom-up from the societal perspective.

RESULTS: Each year around 303,083 (3.3%) of the Austrian population develops RSV-ARI, 1,531 (0,5%) patients were hospitalized; 169 people (0.1%) die. The risk groups under consideration account for 75,783 RSV-ARIs, 413 of which are hospitalized.

The total COI due to RSV-ARI amount to 247.63 million€ per year; with direct costs accounting for 16.5% or 40.82 million€ and indirect costs for 83.5% or 206.81 million€. In terms of cost components, doctor's consultations accounted for the largest share of 14.19 million€ (34.8%), followed by the costs of inpatient stays of 9.62 million€ plus 1.04 million€ for ICU stays (16.1% in total). 8.41 million€ (20.6%) is attributable to pharmaceuticals.

CONCLUSIONS: Our findings demonstrate a substantial annual RSV-attributable healthcare resource-use and costs in Austria across different age groups, with the highest burden in infants and those aged ≥60 years. These data may be useful for policymakers to guide future RSV vaccination programs.