Skip to main content
Erschienen in: PharmacoEconomics 5/2004

01.04.2004 | Original Research Article

Economic Impact of Respiratory Syncytial Virus-Related Illness in the US

An Analysis of National Databases

verfasst von: L. Clark Paramore, Vincent Ciuryla, Gabrielle Ciesla, Larry Liu

Erschienen in: PharmacoEconomics | Ausgabe 5/2004

Einloggen, um Zugang zu erhalten

Abstract

Objective: To determine the impact of respiratory syncytial virus (RSV) infection on healthcare resource use and costs in the US from the third-party payer perspective.
Design: The study retrospectively analysed cross-sectional medical encounter data from three federally funded databases that comprise nationally representative samples of hospital inpatient stays, physician office visits and visits to hospital outpatient departments and emergency rooms.
Methods: Identification of RSV infection-related medical encounters was based on the occurrence of RSV-specific International Classification of Diseases (9th Edition)-Clinical Modification diagnosis codes (079.6, 466.11, 480.1) as principal discharge diagnoses or the assumption that 10–15% of all otitis media visits were due to RSV infection. Outpatient drug costs were estimated based on average wholesale price, and physician fees and test/procedure costs were estimated based on prevailing national fees. Inpatient costs were estimated from total billed charges using a cost-to-charge ratio of 0.53.
Results: In 2000, nearly 98% of RSV infection-related hospitalisations occurred in children <5 years old. There were approximately 86 000 hospitalisations, 1.7 million office visits, 402 000 emergency room visits and 236 000 hospital outpatient visits for children <5 years old that were attributable to RSV infection. Total annual direct medical costs for all RSV infection-related hospitalisations ($US394 million) and other medical encounters ($US258 million) for children <5 years old were estimated at $US652 million in 2000. Otitis media was a major cost driver for physician visits. RSV infection-related hospitalisations increased from 1993 to 2000, but average costs per hospitalisation were relatively stable.
Conclusion: Treatment of RSV infection-related illness represents a significant healthcare burden in the US. The economic impact of ambulatory care for RSV infection-related illness could be as important as that for RSV infection-related hospitalisation.
Fußnoten
1
The code 466.11 was not available prior to 1996. Estimates based on ICD-9-CM code 466.1 (acute bronchiolitis) for years 1993–1995, with adjustment to reflect the proportion of hospitalisations in the period 1996–2000 that had a code of 466.11 (versus 466.19).
 
2
The documentation for the NAMCS and NHAMCS states that estimates of visit characteristics (e.g. age, gender, types of drugs prescribed) based on a sample size of <30 visit records are not reliable. Given that the number of visit records in each database with RSV infection-specific diagnoses (i.e. 079.6, 466.11, 4801.) was <30, RSV infection-related costs were estimated based on resource use obtained from records with a diagnosis of 466.1 (acute bronchiolitis). It was assumed that visits with this diagnosis would have similar resource use patterns compared with the visits that recorded RSV-infection specific diagnoses.
 
Literatur
1.
Zurück zum Zitat Hall CB, McCarthy CA. Respiratory syncytial virus. In: Mandell GL, Bennett JE, Dolin R, editors. Principles and practice of infectious diseases. 5th ed. New York: Churchill Livingstone, 2000: 1782–801 Hall CB, McCarthy CA. Respiratory syncytial virus. In: Mandell GL, Bennett JE, Dolin R, editors. Principles and practice of infectious diseases. 5th ed. New York: Churchill Livingstone, 2000: 1782–801
2.
Zurück zum Zitat Hall CB. Respiratory syncytial virus and parainfluenza virus. N Engl J Med 2001; 344: 1917–28PubMedCrossRef Hall CB. Respiratory syncytial virus and parainfluenza virus. N Engl J Med 2001; 344: 1917–28PubMedCrossRef
3.
Zurück zum Zitat Holberg CJ, Wright AL, Martinez FD, et al. Risk factors for respiratory syncytial virus-associated lower respiratory illness in the first year of life. Am J Epidemiol 1991; 133: 1135–51PubMed Holberg CJ, Wright AL, Martinez FD, et al. Risk factors for respiratory syncytial virus-associated lower respiratory illness in the first year of life. Am J Epidemiol 1991; 133: 1135–51PubMed
4.
Zurück zum Zitat Boyce TG, Mellen BG, Mitchel Jr EF, et al. Rates of hospitalization for respiratory syncytial virus infection among children in Medicaid. J Pediatr 2000; 137: 865–70PubMedCrossRef Boyce TG, Mellen BG, Mitchel Jr EF, et al. Rates of hospitalization for respiratory syncytial virus infection among children in Medicaid. J Pediatr 2000; 137: 865–70PubMedCrossRef
5.
Zurück zum Zitat Anderson LJ. Respiratory syncytial virus vaccines for otitis media. Vaccine 2001; 19: S59–65CrossRef Anderson LJ. Respiratory syncytial virus vaccines for otitis media. Vaccine 2001; 19: S59–65CrossRef
6.
Zurück zum Zitat Pitkaranta A, Virolainen A, Jero J, et al. Detection of rhinovirus, respiratory syncytial virus, and coronavirus infections in acute otitis media by reverse transcriptase polymerase chain reaction. Pediatrics 1998; 102: 291–5PubMedCrossRef Pitkaranta A, Virolainen A, Jero J, et al. Detection of rhinovirus, respiratory syncytial virus, and coronavirus infections in acute otitis media by reverse transcriptase polymerase chain reaction. Pediatrics 1998; 102: 291–5PubMedCrossRef
7.
Zurück zum Zitat Vesa S, Kleemola M, Blomqvist S, et al. Epidemiology of documented viral respiratory infections and acute otitis media in a cohort of children followed from two to twenty-four months of age. Pediatr Infect Dis J 2001; 20: 574–81PubMedCrossRef Vesa S, Kleemola M, Blomqvist S, et al. Epidemiology of documented viral respiratory infections and acute otitis media in a cohort of children followed from two to twenty-four months of age. Pediatr Infect Dis J 2001; 20: 574–81PubMedCrossRef
8.
Zurück zum Zitat American Academy of Pediatrics, Committee on Infectious Diseases and Committee on Fetus and Newborn. Prevention of respiratory syncytial virus infections: indications for the use of palivizumab and update on the use of RSV-IGIV. Pediatrics 1998; 102: 1211–6CrossRef American Academy of Pediatrics, Committee on Infectious Diseases and Committee on Fetus and Newborn. Prevention of respiratory syncytial virus infections: indications for the use of palivizumab and update on the use of RSV-IGIV. Pediatrics 1998; 102: 1211–6CrossRef
9.
Zurück zum Zitat Stang P. The economic burden of respiratory syncytial virusassociated bronchiolitis hospitalizations. Arch Pediatr Adolesc Med 2001; 155: 95–6PubMed Stang P. The economic burden of respiratory syncytial virusassociated bronchiolitis hospitalizations. Arch Pediatr Adolesc Med 2001; 155: 95–6PubMed
10.
Zurück zum Zitat Howard TS, Hoffman LH, Slang PE, et al. Respiratory syncytial virus pneumonia in the hospital setting: length of stay, charges, and mortality. J Pediatr 2000; 137: 227–32PubMedCrossRef Howard TS, Hoffman LH, Slang PE, et al. Respiratory syncytial virus pneumonia in the hospital setting: length of stay, charges, and mortality. J Pediatr 2000; 137: 227–32PubMedCrossRef
11.
Zurück zum Zitat Leader S, Kohlhase K. Respiratory syncytial virus-coded pediatric hospitalizations, 1997 to 1999. Pediatr Infect Dis J 2002; 21 (7): 629–32PubMedCrossRef Leader S, Kohlhase K. Respiratory syncytial virus-coded pediatric hospitalizations, 1997 to 1999. Pediatr Infect Dis J 2002; 21 (7): 629–32PubMedCrossRef
12.
Zurück zum Zitat Center for Medicare and Medicaid Services (CMS). Data on hospitals’ cost-to-charge ratios. CMS public use files [online]. Available from URL: blip: //cms.hhs.gov/providers/ pufdownload/default.asp. [Accessed 2002 Sep 23] Center for Medicare and Medicaid Services (CMS). Data on hospitals’ cost-to-charge ratios. CMS public use files [online]. Available from URL: blip: //cms.hhs.gov/providers/ pufdownload/default.asp. [Accessed 2002 Sep 23]
13.
Zurück zum Zitat US Bureau of Labor Statistics. Consumer price index [database online]. All urban consumers, US city average, medical care. Available from URL: blip: //146.142.4.24/cgi-bin/ surveymost?.cu. [Accessed 2002 Jul 31] US Bureau of Labor Statistics. Consumer price index [database online]. All urban consumers, US city average, medical care. Available from URL: blip: //146.142.4.24/cgi-bin/ surveymost?.cu. [Accessed 2002 Jul 31]
14.
Zurück zum Zitat 2002 Drug topics© RED BOOK©. Montvale (NJ): Medical Economics, 2002 2002 Drug topics© RED BOOK©. Montvale (NJ): Medical Economics, 2002
15.
Zurück zum Zitat Physicians fee & coding guide (a comprehensive fee & coding reference). Augusta (GA): HealthCare Consultants of America Inc., 2002 Physicians fee & coding guide (a comprehensive fee & coding reference). Augusta (GA): HealthCare Consultants of America Inc., 2002
16.
Zurück zum Zitat Kim HW, Arrobio JO, Brandt CD, et al. Epidemiology of respiratory syncytial virus infection in Washington, DC: I. importance of the virus in different respiratory tract disease syndromes and temporal distribution of infection. Am J Epidemiol 1973; 98: 216–25PubMed Kim HW, Arrobio JO, Brandt CD, et al. Epidemiology of respiratory syncytial virus infection in Washington, DC: I. importance of the virus in different respiratory tract disease syndromes and temporal distribution of infection. Am J Epidemiol 1973; 98: 216–25PubMed
17.
Zurück zum Zitat Shay DK, Holman RC, Newman RD, et al. Bronchiolitisassociated hospitalizations among US children, 1980–1996. JAMA 1999; 282: 1440–6PubMedCrossRef Shay DK, Holman RC, Newman RD, et al. Bronchiolitisassociated hospitalizations among US children, 1980–1996. JAMA 1999; 282: 1440–6PubMedCrossRef
18.
Zurück zum Zitat Bredenberg HK, Graham BS. Hospitalization costs of respiratory syncytial virus infection. Pediatr Infect Dis J 2001; 20: 1100–1PubMedCrossRef Bredenberg HK, Graham BS. Hospitalization costs of respiratory syncytial virus infection. Pediatr Infect Dis J 2001; 20: 1100–1PubMedCrossRef
19.
Zurück zum Zitat Stevens TP, Sinkin RA, Hall CB, et al. Respiratory syncytial virus and premature infants born at 32 weeks’ gestation or earlier: hospitalization and economic implications of prophylaxis. Arch Pediatr Adolesc Med 2000; 154: 55–61PubMed Stevens TP, Sinkin RA, Hall CB, et al. Respiratory syncytial virus and premature infants born at 32 weeks’ gestation or earlier: hospitalization and economic implications of prophylaxis. Arch Pediatr Adolesc Med 2000; 154: 55–61PubMed
20.
Zurück zum Zitat Lofland III, Touch SM, O’Connor JP, et al. Palivizumab for respiratory syncytial virus prophylaxis in high-risk infants: a cost-effectiveness analysis. Clin Ther 2000; 22 (11): 1357–69PubMedCrossRef Lofland III, Touch SM, O’Connor JP, et al. Palivizumab for respiratory syncytial virus prophylaxis in high-risk infants: a cost-effectiveness analysis. Clin Ther 2000; 22 (11): 1357–69PubMedCrossRef
21.
Zurück zum Zitat Langley JM, Wang EEL, Law III, et al. Economic evaluation of respiratory syncytial virus infection in Canadian children: a Pediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study. J Pediatr 1997; 131: 113–7PubMedCrossRef Langley JM, Wang EEL, Law III, et al. Economic evaluation of respiratory syncytial virus infection in Canadian children: a Pediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study. J Pediatr 1997; 131: 113–7PubMedCrossRef
22.
Zurück zum Zitat Heikkinen T. The role of respiratory viruses in otitis media. Vaccine 2001; 19: S51–5CrossRef Heikkinen T. The role of respiratory viruses in otitis media. Vaccine 2001; 19: S51–5CrossRef
23.
Zurück zum Zitat Han LL, Alexander JP, Anderson LJ. Respiratory syncytial virus pneumonia among the elderly: an assessment of disease burden. J Infect Dis 1999; 179: 25–30PubMedCrossRef Han LL, Alexander JP, Anderson LJ. Respiratory syncytial virus pneumonia among the elderly: an assessment of disease burden. J Infect Dis 1999; 179: 25–30PubMedCrossRef
24.
Zurück zum Zitat 24. Martinez FD. Respiratory syncytial virus bronchiolitis and the pathogenesis of childhood asthma. Pediatr Infect Dis 12003; 22 (2 Suppl.): S76–82 24. Martinez FD. Respiratory syncytial virus bronchiolitis and the pathogenesis of childhood asthma. Pediatr Infect Dis 12003; 22 (2 Suppl.): S76–82
25.
Zurück zum Zitat Sigurs N. Epidemiologic and clinical evidence of a respiratory syncytial virus-reactive airway disease link. Am J Respir Crit Care Med 2001; 163: S2–6 Sigurs N. Epidemiologic and clinical evidence of a respiratory syncytial virus-reactive airway disease link. Am J Respir Crit Care Med 2001; 163: S2–6
Metadaten
Titel
Economic Impact of Respiratory Syncytial Virus-Related Illness in the US
An Analysis of National Databases
verfasst von
L. Clark Paramore
Vincent Ciuryla
Gabrielle Ciesla
Larry Liu
Publikationsdatum
01.04.2004
Verlag
Springer International Publishing
Erschienen in
PharmacoEconomics / Ausgabe 5/2004
Print ISSN: 1170-7690
Elektronische ISSN: 1179-2027
DOI
https://doi.org/10.2165/00019053-200422050-00001

Weitere Artikel der Ausgabe 5/2004

PharmacoEconomics 5/2004 Zur Ausgabe