OBJECTIVES: Respiratory syncytial virus (RSV) is a major cause of respiratory infection among children. The economic burden of RSV has been mainly driven by hospitalization costs. This study aimed to quantify the costs of hospitalized episodes and estimate the total economic burden of RSV in children <18 years admitted to the Spanish National Healthcare System between 2016–2019.

METHODS: A retrospective observational study was conducted using a national hospital discharge database, that reports >90% of admissions. Children aged <18 years hospitalized for RSV-specific ICD-10 codes were included. The mean cost per hospitalization episode (€, 2022) was reported by age group (0–5, 6–11, 12–23 months, 2–5 and 6–17 years), by risk category (low and high) and by prematurity among infants aged <1 year. Total annual hospitalization costs were calculated from population incidence rates previously reported in the same population and the mean cost per episode.

RESULTS: A total of 45,799 children, including 262 pre-term, were hospitalized with RSV during the study period. The mean cost per hospitalization episode was higher for RSV cases aged 0–5 months with at least one risk factor (€4,768 high vs €2,852 low risk) while the mean cost ranged from €3,664–4,413 for high risk and €2,733–3,529 for low-risk children of other ages and from €4,332 to €4,594 in pre-term infants. Total annual estimated costs increased during the study period, from €35.4 in 2016 to 44.8 million in 2019, with infants aged <6 months accounting for 66% (2016) and 59% (2019) of all hospitalization costs.

CONCLUSIONS: RSV infection has a substantial economic burden amongst children in Spain, especially among infants <6 months.