Background
Methods
Results
Study selection
Characteristics of Included Studies
Income groupa | Setting | Author/year | Intervention(s) evaluated | Study objective | Key assumptions | Key measures and results |
---|---|---|---|---|---|---|
UMIC | Argentina (ARG) | Farina et al. (2002) [26] | Short-acting mAb palivizumab (PVZ) | To evaluate the cost-effectiveness of PVZ given to premature infants (< 24 months old) with bronchopulmonary dysplasia (BPD) born in a hospital at < 35 weeks and < 28 weeks | Intervention cost: $656 Intervention efficacy: 55% Duration of protection: not reported (NR) Approach: Retrospective cohort study | Outcome measure: Incremental cost-effectiveness ratio (ICER) in USD ($)/hospitalisation averted Results: $15,538 |
UMIC | Argentina (ARG) | Rodriguez et al., (2008) [41] | PVZ | To perform a cost-effectiveness analysis on PVZ administration for the prevention of RSV-related hospitalisation rate in premature infants (< 24 months old) with and without BPD and with and without siblings in a hospital in Argentina | Intervention cost: $792 Intervention efficacy: 55% Duration of protection: NR Approach: Retrospective cohort study | Outcome measure: ICER $/hospitalisation averted Result: $10,456 among those without BPD and with siblings; $16,837 among those with BPD and with siblings; $34,088 among those with BPD and without siblings; $71,226 among those without BPD and without siblings |
UMIC | China (CHN) | Liu et al., (2021) [23] | Maternal immunisation (MI), long-acting mAb, paediatric immunisation (PI) | To evaluate the threshold strategy cost (TSC) of RSV interventions (the maximum cost per child for an intervention to be cost-effective) | Intervention cost: NR Intervention efficacy: MI 71.6%; mAb 100%; PI 100% waning to 70% by year 5 Duration of protection: MI 4 months; mAb time-varying; PI time-varying Approach: Static cohort model | Outcome measure: TSC Result: Under willingness-to-pay of 1 GDP per capita per QALY gained, the TSC of RSV intervention ranged between $2.40 and $14.70 for MI; $19.90 and $144.20 for mAb; $28.70 and $201 for PI |
UMIC | Mexico (MEX) | Salinas-Escudero et al., (2012) [29] | PVZ | Evaluated the cost-effectiveness of PVZ prophylaxis for the reduction of RSV-associated complications in preterm patients (< 32 weeks and < 29 weeks) during RSV season in Mexico | Intervention cost: $661 Intervention efficacy: 55% Duration of protection: NR Approach: Decision tree model | Outcome measure: ICER $/QALY Result: $17,532 among preterm births < 29 weeks and $20,760 among preterm born 29–32 weeks |
UMIC | Turkey (TUR) | Oncel et al., (2012) [30] | PVZ | Evaluate the cost-effectiveness of RSV prophylaxis with PVZ in infants (< 24 months) from two hospitals in Turkey | Intervention cost: $516 Intervention efficacy: NR Duration of protection: NR Approach: Retrospective cohort study | Outcome measure: Average (mean) cost of treatment Result: $5019 for those treated with PVZ versus $1934 for those untreated |
UMIC | Turkey (TUR) | Pouwels et al., (2016) [31] | MI, PI | To evaluate the potential cost-effectiveness of RSV vaccination in infants and/or pregnant women in Turkey | Intervention cost: MI $13; PI $13 Intervention efficacy: MI 60%; PI 60% Duration of protection: MI 5 months; PI 2 years Approach: Multi-cohort static Markov model | Outcome measure: ICER $/QALY Result: MI TL 60,638; PI TL 51,969 |
UMIC | Malaysia (MYS) | Chan et al., (2003) [32] | PVZ | Determine the direct cost of resource utilisation in the treatment of children hospitalised with RSV chest infection and the potential cost savings with passive immunisation for high-risk infants | Intervention cost: $3360 Intervention efficacy: 55% Duration of protection: NR Approach: Retrospective cohort study | Outcome measure: ICER $/hospitalisation averted Result: $2921 |
Lower- middle-income country | Global (Gavi countries) | Li et al., (2020) [5] | MI, long-acting mAb | Use a country-specific model to evaluate the key drivers of the cost-effectiveness of maternal vaccination and infant mAb for 72 Gavi countries | Intervention cost: MI $3; mAb $6 Intervention efficacy: MI 75%; mAb 60% Duration of protection: MI 5 months; mAb 6 months Approach: Multi-country static cohort model | Outcome measure: ICER $/DALY Result: MI $1893; mAb $2769 |
Low- and middle-income countries | Global (low- and middle-income countries) | Baral et al., (2021) [28] | MI, long-acting mAb | Use a country-specific model, evaluate the potential impact and cost-effectiveness of two interventions to prevent childhood RSV—a maternal vaccine and a mAb | Intervention cost: MI $3.22; mAb $3.22 Intervention efficacy: MI 42%; mAb 70% Duration of protection: MI 6 months; mAb 6 months Approach: Static cohort model | Outcome measure: ICER $/DALY Result: MI: $1342; mAb: $431 |
LIC | Mali (MLI) | Laufer et al., (2021) [27] | PVZ, MI, long-acting mAb | Model the estimated likelihood of RSV preventive interventions being cost-effective in Mali | Intervention cost: PVZ NR; MI $1.38; mAb $1.38 Intervention efficacy: PVZ 55%; MI 56%; mAb 70% Duration of protection: PVZ 1mo; MI 3 months; mAb 5 months Approach: Decision tree model | Outcome measure: ICER $/DALY Result: PVZ $4280; MI $8020; mAb $1656 |
Income groupa | Setting | Author | Study objective, sample size (n), and population | Key measures and results |
---|---|---|---|---|
UMIC | Argentina (ARG) | Marcone et al., (2015) [34] | Objective: Estimate the cost of hospitalisations due to aetiology-specific ALRI among children aged ≤ 5 years and costs incurred during their hospitalisations (n = 358) Subgroups analysed: Inpatient only Approach: Prospective cohort design, administrative hospital records | Outcome measure: Direct medical costs Length of stay: 3 days (IQR: 2–4) Results: $529 per hospitalisation episode |
UMIC | China (CHN) | Zhang et al., (2014) [36] | Objective: Estimate the direct medical cost of laboratory-proven RSV children hospitalised in Suzhou, China (n = 2721) Subgroups analysed: Ward and ICU Approach: Retrospective review of medical records | Outcome measure: Direct medical costs Length of stay: 8 days (IQR: 7–9) Results: $565.36 per episode for children seen in ward; $909.65 per episode per children admitted to ICU |
UMIC | Colombia (COL) | Rodriguez-Martinez (2020) [25] | Objective: Evaluate the direct medical costs associated with bronchiolitis hospitalisations caused by infection with RSV among children aged < 2 years in Bogota, Colombia (n = 89) Subgroups analysed: Ward and ICU Approach: Retrospective review of medical records | Outcome measure: Direct medical costs Length of stay: 7 days (+ / − sd 4.4 days) Results: US$518.0 per episode per children seen in ward; $2749.7 per episode per children admitted to ICU |
UMIC | Colombia (COL) | Buendia et al., (2021) [37] | Objective: Evaluate the medical costs associated with bronchiolitis hospitalisations caused by RSV infection among infants aged < 2 years in Colombia (n = 193) Subgroups analysed: Inpatient only Approach: Retrospective review of medical invoice and health records | Outcome measure: Direct and indirect medical costs Length of stay: 5.88 days Results: Cost per episode for children in ICU $580 (direct); $101 (indirect) |
UMIC | Malaysia (MYS) | Chan et al., (2003) [32] | Objective: Determine the direct cost of resource utilisation in the treatment of children hospitalised with RSV chest infection and the potential cost savings with passive immunisation for high-risk infants (n = 216) Subgroups analysed: Full-term and pre-term children Approach: Retrospective review of medical records and resource use data | Outcome measure: Direct medical costs Length of stay: 3.9 days for full-term, 9.0 days for pre-term Results: Direct cost per episode among full-term children: $216; and among pre-term: $2485 |
UMIC | Malaysia (MYS) | Sam et al., (2021) [39] | Objective: Determine the socioeconomic burden of children < 5 years hospitalised with ARI by interviewing patients’ carers and obtaining unsubsidised hospital costs (n = 74) Subgroups analysed: Inpatient only Approach: Prospective study | Outcome measure: Direct medical, non-medical costs, and indirect costs Length of stay: 4 days (IQR: 3–5) Results: Direct medical cost per episode $756; non-medical costs $31; indirect costs $98 |
UMIC | Mexico (MEX) | Comas-Garcia et al., (2020) [40] | Objective: Assess the impact and cost of nosocomial RSV infections in a NICU (n = 24 RSV, 24 control) Subgroups analysed: Inpatient only Approach: Retrospective cohort study | Outcome measure: Direct medical costs Length of stay: 24 days (vs 13 days for control of hospitalised with no RSV infection) Results: Direct medical cost of nosocomial RSV infection among children admitted in NICU $6922 per episode |
UMIC | Thailand (THA) | Bhuket et al., (2002) [33] | Objective: Determine the economic burden in the management of ALRI from the patient’s perspective at Takhli District. Hospital (n = 165) Subgroups analysed: Outpatient and inpatient Approach: Cross-sectional interviews and records review | Outcome measure: Direct medical, direct non-medical, and indirect medical costs Length of stay: NR Results: Cost per episode for outpatient $312 (direct), $118 (non-medical), $73 (indirect); cost per episode for inpatient $1134 (direct), $387 (non-medical), $222 (indirect) |
Lower-middle-income country | Bangladesh (BGD) | Bhuiyan et al., (2017) [35] | Objective: Estimate the costs of severe RSV illness requiring hospitalisation among children < 5 years and the associated financial impact on households in Bangladesh (n = 39) Subgroups analysed: inpatient only Approach: Cross-sectional interviews | Outcome measure: Direct and indirect medical costs, household costs Length of stay: 5 days (IQR: 3–6) Results: Total cost per episode of RSV $94; direct cost per episode $62; indirect cost per episode $19; household out-of-pocket costs $143 (24% of household monthly income) |
LIC | Malawi (MWI) | Baral et al. (2020) [38] | Objective: Estimate the household and health system costs of managing RSV and other respiratory pathogens in Malawian infants (n = 426) Subgroups analysed: outpatient and inpatient Approach: Cross-sectional interviews and medical record reviews | Outcome measure: Direct and indirect medical costs, household costs Length of stay: 3 days (IQR: 2–4) Results: Total cost per episode of RSV $62.26 (inpatient) and $12.51 (outpatient); household costs accounted for 20% of cost per episode which for low-income families was 32% of monthly household income |