Global Health Economics and Value Assessment, Sanofi Pasteur, Lyon, France.
Evidence Synthesis & Modeling, Xcenda, L.L.C., Carrollton, Texas, USA.
Influenza Other Respir Viruses. 2022 May;16(3):376-385. doi: 10.1111/irv.12963. Epub 2022 Feb 5.
While the economic burden of influenza infection is well described among adults aged 65 and older, less is known about younger adults. A systematic literature review was conducted to describe the economic burden of seasonal influenza in adults aged 18 to 64 years, to identify the main determinants of direct and indirect costs, and to highlight any gaps in the existing published evidence. MEDLINE and Embase were searched from 2007 to February 7, 2020, for studies reporting primary influenza-related cost data (direct or indirect) or absenteeism data. Of the 2613 publications screened, 51 studies were included in this review. Half of them were conducted in the United States, and 71% of them described patients with influenza-like illness rather than laboratory-confirmed disease. Only 12 studies reported cost data specifically for at-risk populations. Extracted data highlighted that within the 18- to 64-year-old group, up to 88% of the economic burden of influenza was attributable to indirect costs, and up to 75% of overall direct costs were attributable to hospitalizations. Furthermore, within the 18- to 64-year-old group, influenza-related costs increased with age and underlying medical conditions. The reported cost of influenza-related hospitalizations was found to be up to 2.5 times higher among at-risk populations compared with not-at-risk populations. This review documents the considerable economic impact of influenza among adults aged 18 to 64. In this age group, most of the influenza costs are indirect, which are generally not recognized by decision makers. Future studies should focus on at-risk subgroups, lab-confirmed cases, and European countries.
虽然老年人（65 岁及以上）流感感染的经济负担已得到充分描述，但对于年轻人的了解较少。本系统文献综述旨在描述 18 至 64 岁成年人季节性流感的经济负担，确定直接和间接成本的主要决定因素，并强调现有已发表证据中的空白。从 2007 年至 2020 年 2 月 7 日，我们在 MEDLINE 和 Embase 上检索了报告主要流感相关成本数据（直接或间接）或缺勤数据的研究。在筛选出的 2613 篇论文中，有 51 篇论文被纳入本综述。其中一半的研究在美国进行，其中 71%的研究描述了流感样疾病患者，而不是实验室确诊疾病患者。只有 12 项研究专门报告了高危人群的成本数据。提取的数据强调，在 18 至 64 岁人群中，流感的经济负担高达 88%归因于间接成本，而总直接成本的 75%归因于住院治疗。此外，在 18 至 64 岁人群中，流感相关成本随年龄和潜在疾病状况的增加而增加。与非高危人群相比，高危人群的流感相关住院费用被发现高达 2.5 倍。本综述记录了 18 至 64 岁成年人中流感的巨大经济影响。在这个年龄组中，大部分流感相关成本是间接成本，这通常未被决策者所认识。未来的研究应侧重于高危亚组、实验室确诊病例和欧洲国家。
