Respiratory Syncytial Virus–Related Complications and Healthcare Costs Among a Medicare-Insured Population in the United States

• Published in: Open forum infectious diseases Vol. 10; no. 5; p. ofad203
• Main Authors: DeMartino, Jessica K, Lafeuille, Marie-Hélène, Emond, Bruno, Rossi, Carmine, Wang, Jingru, Liu, Stephanie, Lefebvre, Patrick, Krishnarajah, Girishanthy
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 01.05.2023
• Subjects: Major; predictors; older adults; costs; complications; respiratory syncytial virus
• ISSN: 2328-8957; 2328-8957
• DOI: 10.1093/ofid/ofad203

Abstract Background Literature describing respiratory syncytial virus (RSV)–related complications in older adults in the United States is scarce. This study described risk factors of RSV-related complications and healthcare costs of Medicare-insured patients aged ≥60 years with medically attended RSV. Methods 100% Medicare Research Identifiable Files (1 January 2007–31 December 2019) were used to identify adults aged ≥60 years with RSV (index: first diagnosis date). Predictors of ≥1 RSV-related complication (ie, pneumonia, acute respiratory failure, congestive heart failure, hypoxia/dyspnea, non-RSV lower/upper respiratory tract infections, or chronic respiratory disease) during the up to 6-month post–RSV diagnosis period were identified. Patients with all aforementioned diagnoses during the 6 months pre-index could not be evaluated for a complication and were therefore ineligible for analyses. Differences between 6-month pre- and post-index total all-cause and respiratory/infection-related healthcare costs were assessed. Results Overall, 175 392 patients with RSV were identified. Post–RSV diagnosis, 47.9% had ≥1 RSV-related complication, with mean time-to-event of 1.0 month. The most common complications were pneumonia (24.0%), chronic respiratory disease (23.6%), and hypoxia or dyspnea (22.0%). Baseline predictors of ≥1 RSV-related complication included having previous diagnoses for complication/comorbidity listed in the Methods, hypoxemia, chemotherapy, chest radiograph, stem cell transplant, and anti-asthmatic and bronchodilator use. Total all-cause and respiratory/infection-related healthcare costs were $7797 and $8863 higher, respectively, post-index versus pre-index (both P < .001). Conclusions In this real-world study, almost half of patients with medically attended RSV experienced an RSV-related complication within 1 month post–RSV diagnosis, and costs significantly increased post-diagnosis. Having a complication/comorbidity pre-RSV predicted a higher risk of developing a different complication post–RSV infection. In this real-world study, nearly half of Medicare beneficiaries experienced a respiratory syncytial virus (RSV)–related complication within 1 month of RSV diagnosis. Presence of complications/comorbidities of interest pre–RSV diagnosis predicted a higher risk of having a different complication following diagnosis.