BACKGROUND: While older adults have been the primary focus of adult RSV prevention, emerging evidence indicates that adults aged 18-59 years also experience significant disease burden, especially those at increased risk of severe disease due to certain chronic medical conditions. This study estimates the annual direct healthcare and indirect costs of RSV among United States (US) adults aged 18-59 years at increased risk of severe disease.
METHODS: A decision-analytic model was used to estimate RSV cases, RSV-related deaths, and their associated costs. Incidence rates and cost inputs were derived from published literature. Direct costs (2023 US dollars) were estimated for medically attended (MA) RSV cases, including hospitalizations, emergency department (ED) and outpatient (OP) visits. Indirect costs were calculated for productivity losses due to RSV-related morbidity, mortality, and caregiving. Sensitivity analyses were also conducted.
RESULTS: Among adults 50-59 years at increased risk, the model estimated 425,000 MA-RSV cases annually, including 34,000 hospitalizations, 28,000 ED visits, and $2.1 billion in total costs (direct: $1.31 billion; indirect: $0.83 billion). While only 8% of MA-RSV cases were hospitalized, they resulted in nearly 1,500 deaths and 30% of direct costs. Similarly, the burden was substantial among adults 18-49 years at increased risk with an estimated 943,000 MA cases annually, including 28,000 hospitalizations, 81,000 ED visits and nearly $4 billion in total costs, with 38% of this burden from productivity losses. Sensitivity analyses demonstrated significant variability in the economic burden under alternate assumptions about RSV incidence, costs of RSV hospitalization and RSV mortality.
CONCLUSIONS: The findings highlight a significant economic burden of RSV among US adults aged 18-59 years at increased risk of severe disease, with total costs reaching $6 billion annually. These results underscore the importance of targeted prevention strategies to reduce RSV-related healthcare utilization, productivity losses, and associated costs in this population.
