Cost determinants among adults hospitalized with respiratory syncytial virus in the United States, 2017–2019

Choi, Yoonyoung; Hill-Ricciuti, Alexandra; Branche, Angela; Sieling, William; Saiman, Lisa; Walsh, Edward E.; Phillips, Matthew; Falsey, Ann R.; Finelli, Lyn

doi:10.1111/irv.12912

Cited by 27 publications

(24 citation statements)

References 23 publications

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“…There are limited data on RSV‐specific MRU. In a recent retrospective claims study among hospitalized adults in New York state, the average cost of an RSV‐associated hospitalization was $8403, and the total annual cost of RSV‐associated hospitalizations in the United States was estimated at $1.2 billion 20 . Additionally, in a different community cohort study in New York City, among RSV‐positive hospitalized adults aged ≥65 years, the majority received chest X‐rays, antibiotics, and steroids; the mean length of hospital stay in this population was 6.6 days 12 .…”

Section: Introductionmentioning

confidence: 99%

Risk factors and medical resource utilization in US adults hospitalized with influenza or respiratory syncytial virus in the Hospitalized Acute Respiratory Tract Infection study

Hartnett

Donga

Ispas

et al. 2022

Influenza Resp Viruses

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Background Influenza and respiratory syncytial virus (RSV) are associated with substantial morbidity and mortality in the United States. We assessed risk factors for severe disease and medical resource utilization (MRU) among US adults hospitalized with influenza or RSV in the Hospitalized Acute Respiratory Tract Infection (HARTI) study. Methods HARTI was a prospective global (40 centers, 12 countries) epidemiological study of adults hospitalized with acute respiratory tract infections conducted across the 2017–2019 epidemic seasons. Patients with confirmed influenza or RSV were followed up to 3 months post‐discharge. Baseline characteristics, prevalence of core risk factors (CRFs) for severe disease (age ≥65 years, chronic heart or renal disease, chronic obstructive pulmonary disease, or asthma), and MRU were summarized descriptively. Results The US cohort included 280 influenza‐positive and 120 RSV‐positive patients. RSV patients were older (mean: 63.1 vs. 59.7 years) and a higher proportion had CRFs (87.5% vs. 81.4%). Among those with CRFs (influenza, n = 153; RSV, n = 99), RSV patients required longer hospitalizations (median length of stay: 4.5 days) and a greater proportion (79.8%) required oxygen supplementation during hospitalization compared with influenza patients (4.0 days and 59.5%, respectively). At 3 months post‐discharge, a greater proportion of RSV patients with CRFs reported use of antibiotics, antitussives, bronchodilators, and inhaled and systemic steroids versus those with influenza and CRFs. Many patients with CRFs reported hospital readmission at 3 months post‐discharge (RSV: 13.4%; influenza: 11.9%). Conclusions MRU during and post‐hospitalization due to RSV in adults is similar to or greater than that of influenza. Enhanced RSV surveillance and preventive and therapeutic interventions are needed.

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Section: Introductionmentioning

confidence: 99%

Risk factors and medical resource utilization in US adults hospitalized with influenza or respiratory syncytial virus in the Hospitalized Acute Respiratory Tract Infection study

Hartnett

Donga

Ispas

et al. 2022

Influenza Resp Viruses

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“…We developed a discrete-event simulation model ( Figure 1 ) with a population of 100 000 adults stratified into age groups of 60 to 64, 65 to 69, 70 to 74, 75 to 79, 80 to 84, and 85 years or older reflecting US demographics [ 10 ]. We considered the prevalence of comorbidities across these age groups ( Supplementary Table 1 ) [ 11 ], which was used in determining the severe outcomes of RSV disease for adults with 0, 1–3, and ≥4 comorbidities [ 12 ].…”

Section: Methodsmentioning

confidence: 99%

Cost-effectiveness of Prefusion F Protein-based Vaccines Against Respiratory Syncytial Virus Disease for Older Adults in the United States

Moghadas,

Shoukat,

Bawden

et al. 2023

Clinical Infectious Diseases

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Background Two prefusion F protein-based vaccines, Arexvy and Abrysvo, have been authorized by the US Food and Drug Administration for protecting older adults against respiratory syncytial virus (RSV)-associated lower respiratory tract illness. We evaluated the health benefits and cost-effectiveness of these vaccines. Methods We developed a discrete-event simulation model, parameterized with the burden of RSV disease including outpatient care, hospitalization, and death for adults aged 60 years or older in the United States. Taking into account the costs associated with these RSV-related outcomes, we calculated the net monetary benefit using quality-adjusted life-year (QALY) gained as a measure of effectiveness and determined the range of price-per-dose (PPD) for Arexvy and Abrysvo vaccination programs to be cost-effective from a societal perspective. Results Using a willingness-to-pay of $95 000 per QALY gained, we found that vaccination programs could be cost-effective for a PPD up to $127 with Arexvy and $118 with Abrysvo over the first RSV season. Achieving an influenza-like vaccination coverage of 66% for the population of older adults in the United States, the budget impact of these programs at the maximum PPD ranged from $6.48 to $6.78 billion. If the benefits of vaccination extend to a second RSV season as reported in clinical trials, we estimated a maximum PPD of $235 for Arexvy and $245 for Abrysvo, with 2-year budget impacts of $11.78 and $12.25 billion, respectively. Conclusions Vaccination of older adults would provide substantial direct health benefits by reducing outcomes associated with RSV-related illness in this population.

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“…[183][184][185] The total costs of healthcare related to RSV in the United States were recently estimated at $1.2 billion annually. 186 Despite the discovery of RSV in 1957, no vaccine against it is authorized at the moment of writing, and its development has been subject to failures over the decades. Administration of a vaccine based on formalin-inactivated RSV developed in the 1960s has been responsible for enhanced respiratory infections and increased mortality risk.…”

Section: Mrna Vaccine Candidates Against Rsvmentioning

confidence: 99%

“…At the same time, RSV is responsible for over 330 thousand hospitalizations of elderly individuals and 14 thousand deaths in this group in the United States alone 183–185 . The total costs of healthcare related to RSV in the United States were recently estimated at $1.2 billion annually 186 …”

Section: Clinical Progress Of Mrna Candidates Beyond Covid‐19mentioning

confidence: 99%

mRNA vaccines: The future of prevention of viral infections?

Rzymski

Szuster‐Ciesielska

Dzieciątkowski

et al. 2023

Journal of Medical Virology

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Messenger RNA (mRNA) vaccines against COVID-19 are the first authorized biological preparations developed using this platform. During the pandemic, their administration has been proven to be a life-saving intervention. Here, we review the main advantages of using mRNA vaccines, identify further technological challenges to be met during the development of the mRNA platform, and provide an update on the clinical progress on leading mRNA vaccine candidates against different viruses that include influenza viruses, human immunodeficiency virus 1, respiratory syncytial virus, Nipah virus, Zika virus, human cytomegalovirus, and Epstein-Barr virus. The prospects and challenges of manufacturing mRNA vaccines in low-income countries are also discussed. The ongoing interest and research in mRNA technology are likely to overcome some existing challenges for this technology (e.g., related to storage conditions and immunogenicity of some components of lipid nanoparticles) and enhance the portfolio of vaccines against diseases for which classical formulations are already authorized. It may also open novel pathways of protection against infections and their consequences for which no safe and efficient immunization methods are currently available.

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Cost determinants among adults hospitalized with respiratory syncytial virus in the United States, 2017–2019

Cited by 27 publications

References 23 publications

Risk factors and medical resource utilization in US adults hospitalized with influenza or respiratory syncytial virus in the Hospitalized Acute Respiratory Tract Infection study

Risk factors and medical resource utilization in US adults hospitalized with influenza or respiratory syncytial virus in the Hospitalized Acute Respiratory Tract Infection study

Cost-effectiveness of Prefusion F Protein-based Vaccines Against Respiratory Syncytial Virus Disease for Older Adults in the United States

mRNA vaccines: The future of prevention of viral infections?

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