The study shows the economic burden of RSV on European children in need of primary care

The study shows the economic burden of RSV on European children in need of primary care

Respiratory tract infections -Syncytial virus (RSV) in children requiring primary careEurosurveillance.

The study sought to provide insights for public health policy and support cost and performance analysis for RSV immunization strategies. RSV infections are a major cause of acute respiratory infections in children, with almost all children having at least one RSV infection by age 2 years. While some children develop a severe form of RSV disease that may require hospitalization, most infections are treated in primary care.

Significant differences in societal costs across age groups and countries

The study included 3,414 children under 5 years of age with acute respiratory tract infection in Belgium, Italy, the Netherlands, Spain and the United Kingdom (UK), 33% of whom tested positive for RSV. Children were recruited from primary care physicians for the RSV seasons 2020/21 (UK only), 2021/22 and 2022/23. For children diagnosed with RSV, primary care costs and parental work absences over 30 days were assessed through questionnaires completed by parents. Calculations of overall economic burden included outpatient healthcare costs and missed workdays by parents, with results stratified by country and by age and the group of children diagnosed with RSV.

The researchers found that RSV infections resulted in a significant economic burden, with costs varying significantly between the five countries participating in this study: average outpatient healthcare costs per RSV episode ranged from EUR 97 in the Netherlands to EUR 300 in Spain and were mostly driven by primary care visits. The cost of parental absence from work ranged from €454 in the UK to €994 in Belgium.

The main sources of costs were repeated visits to doctors and parents missing work to care for their sick children. Health care-related costs were higher for infants aged 1 year, while parental work distance represented a higher proportion of costs for children aged 1 to 5 years. Drug costs to treat RSV infections contributed the least to the overall economic burden across all countries and age groups.

The mean number of primary care visits per child varied from 1.4 in the Netherlands to 3.0 in Spain. There were large differences in hospitalization rates, ranging from 4% of infections, resulting in hospitalizations in the Netherlands and Italy to 44% in Belgium. However, this may be due to the fact that Belgium included data on children in out-of-hours care. The proportion of children prescribed medication ranged from 26% in the UK to 77% in Italy. Parental absence was significant between countries, ranging from 13% of parents reporting absences and an average of 1.3 days absent in Spain to 71% of parents reporting an average of 4.1 days off work in Belgium.

The study has some limitations. There may have been some selection bias by doctors when selecting children, and the study only included costs within 30 days of the first doctor's visit. The Covid-19 pandemic may also have influenced the data. While evidence suggests that self-reported work absenteeism serves as a valid alternative to documented work absenteeism, some assumptions were made due to incomplete information in the data analysis. Based on existing research, all costs were assumed to be related to RSV, regardless of possible infections with other viruses.

The results that are crucial for defining immunization strategies

The differences revealed in the data highlight the importance of considering country-specific cost estimates when defining RSV immunization strategies. These can vary widely due to differences in healthcare systems, caregiving patterns and parental leave policies.

This study also addresses a critical gap in understanding the overall economic impact of RSV infection in childhood, as most studies of the economic burden of RSV to date have focused on the costs associated with RSV-related hospitalization and do not include primary care costs. While infections treated in primary care have lower healthcare costs, they still contribute significantly to the overall economic burden of RSV.

“Our findings are particularly timely given the recent introduction of RSV immunization strategies for infants and the continued development of multiple RSV vaccines for infants and older children.“The authors said.

Sources: