RTI Health Solutions, Research Triangle Park, NC, USA.
RTI Health Solutions, Didsbury, UK.
J Med Econ. 2023 Jan-Dec;26(1):742-759. doi: 10.1080/13696998.2023.2213125.
To capture the economic and healthcare resource utilization (HCRU) burden in older adults due to respiratory syncytial virus (RSV) infection.
An electronic literature search of PubMed, Embase, the Cochrane Library, PsycINFO, and EconLit was conducted for studies of the cost and HCRU outcomes of RSV infection in adult patients, with no language or country restrictions. The search dates for the primary studies were January 1, 2002-May 18, 2022. The methodological quality of included studies was assessed using a modification of the Critical Appraisal Skills Programme (CASP) checklist for economic studies and the Drummond checklist.
Forty-two studies were identified that reported cost or HCRU data associated with RSV infections, with geographic locations across North America, South America, Europe, Asia, and Oceania. Generally, hospitalization costs were highest in the United States (US). Driving factors of increased cost included older age, comorbidities, and length of stay. US studies found that the national direct cost burden of RSV hospitalizations was $1.3 billion for all adults and $1.5-$4.0 billion for adults aged ≥60 years (estimates for other countries were not identified). Studies estimating incremental costs for RSV cases versus controls and costs pre- and post-RSV infection demonstrated higher costs for RSV cases. Hospitalizations accounted for the majority of total costs.
The variability in definitions of cost outcomes, age groups, study seasons, and geographic locations was prohibitive of a meta-analysis and comparisons across studies. Cost and HCRU data were limited per country outside the US, per comorbidity, and in settings other than the inpatient setting. Only one study reported indirect costs, and only the US had national cost burden data.
Despite several data gaps, the economic burden of RSV infections on healthcare systems and payers was found to be substantial, globally, underscoring the need for RSV preventive strategies for reducing this burden.
评估呼吸道合胞病毒（RSV）感染给老年患者带来的经济和医疗资源利用（HCRU）负担。
通过电子文献检索 PubMed、Embase、Cochrane 图书馆、PsycINFO 和 EconLit，检索了成人患者 RSV 感染的成本和 HCRU 结果的研究，无语言或国家限制。初级研究的检索日期为 2002 年 1 月 1 日至 2022 年 5 月 18 日。使用经济研究的批判性评估技能计划（CASP）检查表和 Drummond 检查表对纳入研究的方法学质量进行了评估。
确定了 42 项研究，这些研究报告了与 RSV 感染相关的成本或 HCRU 数据，地理位置涵盖北美、南美、欧洲、亚洲和大洋洲。一般来说，美国（US）的住院费用最高。增加成本的驱动因素包括年龄较大、合并症和住院时间。美国的研究发现，所有成年人的 RSV 住院治疗的国家直接成本负担为 13 亿美元，60 岁以上成年人为 1.5-40 亿美元（未确定其他国家的估计数）。对 RSV 病例与对照的增量成本和 RSV 感染前后的成本进行研究的结果表明，RSV 病例的成本更高。住院治疗占总费用的大部分。
由于成本结果、年龄组、研究季节和地理位置的定义存在差异，因此无法进行荟萃分析和比较研究。除美国以外，每个国家的成本和 HCRU 数据都有限，每个合并症的成本和 HCRU 数据都有限，并且仅限于住院环境以外的环境。只有一项研究报告了间接成本，只有美国有国家成本负担数据。
尽管存在一些数据空白，但全球范围内 RSV 感染对医疗系统和支付者的经济负担是相当大的，这突显了需要制定 RSV 预防策略来减轻这一负担。
