Costs and Complications of Respiratory Syncytial Virus and Acute Respiratory Infections in the Adult Population: Analysis of a German Claims Database

Background Respiratory syncytial virus (RSV) infections pose health and economic burdens to adults. Using claims data, we estimated RSV-associated costs, healthcare resource utilization (HCRU), and complication rates from patients of a nationwide German health insurance database. Methods We analyzed confirmed RSV, RSV-possible, and acute respiratory infection (ARI) cohorts, plus 1:1 matched control cohorts of individuals ≥ 18 years from 2010 to 2019. Matching was performed separately for patients 18–49, 50–59, and ≥ 60 years. Medical costs, HCRU, and sick leave were assessed for inpatients and outpatients. Complications were compared between cases and controls, and logistic regression assessed odds ratios (ORs) for risk. Results Altogether, 2668 confirmed RSV index episodes occurred. In ≥ 60-year-olds, 862 episodes incurred mean excess costs of €3773 (95% confidence interval [CI]: €2956–€4591) per episode during the index quarter and €3286 (95% CI: €1841–€4732) in the following four quarters. Mean costs were €5553 per episode for inpatients and €116 for outpatients. In ≥ 60-year-olds, risk for congestive heart failure hospitalization (OR 2.3; 95% CI: 1.4–3.8), exacerbation of asthma (OR 6.0; 95% CI: 1.7–20.9), and chronic obstructive pulmonary disease (OR 3.9; 95% CI: 2.6–5.8) were higher for confirmed RSV than controls. In younger groups, costs, HCRU, and complications were also higher in cases than controls. The complication frequencies increased with age. RSV-possible episodes incurred mean excess costs of €615 (95% CI: €605–€626) during the index quarter and €610 (95% CI: €583–€637) during the following four quarters, while in the ARI cohort, the excess costs were €1003 (95% CI: €991–€1015) during the index quarter and €1003 (95% CI: €973–€1032) in the following four quarters. For all three cohorts, individuals who had comorbidities, were immunocompromised, or living in long-term care facilities incurred higher costs. Conclusions Confirmed RSV is associated with high excess costs – especially in hospital settings – and HCRU. Complication risk increased with RSV presence. Graphical Abstract