The economic burden of RSV-associated illness in children aged < 5 years, South Africa 2011–2016.
Date
2022-06-21
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Introduction
Data on the economic burden of RSV-associated illness will inform decisions on the
programmatic implementation of maternal vaccines and monoclonal antibodies. We
estimated these costs in fine age bands to allow more accurate cost-effectiveness models to
account for limited duration of protection conferred by short or long acting interventions.
Methods
We conducted a costing study at sentinel sites across South Africa to estimate out-of-pocket
and indirect costs for RSV-associated mild and severe illness. We collected facility-specific
costs for staffing, equipment, services, diagnostic tests and treatment. Using case-based data
we calculated a patient day equivalent (PDE) for RSV-associated hospitalisations or clinic
visits; the PDE was multiplied by the number of days of care to provide a case-cost to the
healthcare system. We estimated the costs in 3-month age intervals in children aged <1 years
and as a single group for children aged 1-4 years. We then applied our data to a modified
version of the World Health Organization tool for estimating mean annual national cost
burden, including medically and non-medically attended RSV-associated illness.
Results
The estimated mean annual cost of RSV-associated Illness in children aged <5 years was
United States dollars ($)137 204 393, of which 81% ($111 742 713) were healthcare system
incurred, 6% ($8 881 612) were out of pocket expenses and 13% ($28 225 801) were indirect
costs. Thirty-three percent ($45 652 677/$137 204 393) of the total cost in children aged <5
years was in the <3-month age group, of which 52% ($71 654 002) were healthcare system
incurred. The costs of non-medically attended cases increased with age from $3 307 218 in
the <3-month age group to $8 603 377 in the 9-11-month age group.
Conclusion
Among children <5 years of age with RSV in South Africa, the highest cost burden was in
young infants; therefore, interventions against RSV targeting this age group are important to
reduce the health and cost burden of RSV-associated illness.