Averin Ahuva, Sato Reiko, Begier Elizabeth, Gessner Bradford D, Snow Vincenza, Cane Alejandro, Quinn Erin, Atwood Mark, Kijauskaite Goda, Weycker Derek
Avalere Health, Boston, MA, USA.
Pfizer Inc., Collegeville, PA, USA.
Vaccine. 2024 Dec 2;42(26):126323. doi: 10.1016/j.vaccine.2024.126323. Epub 2024 Sep 20.
Respiratory syncytial virus (RSV) is a common cause of lower respiratory tract disease (LRTD) among adults and can lead to serious morbidity and mortality; however, evidence on the magnitude of the public health and economic burden of adult RSV-LRTD is limited. This study was undertaken to project annual clinical outcomes and economic costs of medically attended RSV-LRTD among US adults, and to identify subgroups responsible for a disproportionate share of disease burden.
Clinical outcomes of RSV-LRTD were projected for subgroups of US adults defined by age and comorbidity profile (with vs. without chronic/immunocompromising medical conditions) based on corresponding population sizes, episode (disease) rates, and case-fatality rates. Economic costs comprised medical (i.e., direct) costs and non-medical (i.e., indirect) costs of RSV-LRTD, and were generated based on numbers of episodes and unit costs in relation to setting of care, age, and comorbidity profile.
Among 265 million US adults aged ≥18 years in 2023, 6.5 million medically attended episodes of RSV-LRTD were projected to occur including 349,260 requiring hospitalization, 357,892 requiring an emergency department visit (not leading to hospitalization), and 5.8 million requiring other ambulatory care. Direct costs ($15.2 billion) and indirect costs ($9.7 billion) were projected to total $25.0 billion. Persons aged 60-99 years accounted for 31 % of the adult population and over 50 % of the economic burden of RSV-LRTD, while adults aged <60 years with chronic/immunocompromising medical conditions accounted for 10 % of the population and 27 % of the economic burden.
Annual burden of RSV-LRTD among US adults-especially older adults and those of all ages with underlying medical conditions-is substantial. Preventive measures, such as recently approved RSV vaccines, have the potential to yield important improvements in public and patient health, and to reduce the economic burden of RSV-LRTD from the US healthcare system and societal perspectives.
呼吸道合胞病毒（RSV）是成人下呼吸道疾病（LRTD）的常见病因，可导致严重的发病和死亡；然而，关于成人RSV-LRTD的公共卫生和经济负担程度的证据有限。本研究旨在预测美国成人中因医疗就诊的RSV-LRTD的年度临床结局和经济成本，并确定造成疾病负担不成比例的亚组。
根据相应的人口规模、发作（疾病）率和病死率，对按年龄和合并症情况（有或无慢性/免疫功能低下疾病）定义的美国成人亚组的RSV-LRTD临床结局进行预测。经济成本包括RSV-LRTD的医疗（即直接）成本和非医疗（即间接）成本，并根据发作次数和与护理环境、年龄和合并症情况相关的单位成本生成。
在2023年美国2.65亿名18岁及以上的成年人中，预计将发生650万次因医疗就诊的RSV-LRTD发作，其中349,260次需要住院治疗，357,892次需要急诊就诊（未导致住院），580万次需要其他门诊护理。预计直接成本（152亿美元）和间接成本（97亿美元）总计250亿美元。60至99岁的人群占成年人口的31%，承担了超过50%的RSV-LRTD经济负担，而年龄小于60岁且患有慢性/免疫功能低下疾病的成年人占人口的10%，承担了27%的经济负担。
美国成人中RSV-LRTD的年度负担——尤其是老年人以及所有年龄段患有基础疾病的人——相当大。预防措施，如最近批准的RSV疫苗，有可能显著改善公众和患者健康，并从美国医疗保健系统和社会角度减轻RSV-LRTD的经济负担。
