Economic burden of influenza illness among children under 5 years in Suzhou, China: Report from the cost surveys during 2011/12 to 2016/17 influenza seasons

• Published in: Vaccine Vol. 39; no. 8; pp. 1303 - 1309
• Main Authors: Wang, Yin, Chen, Liling, Cheng, Fangfang, Biggerstaff, Matthew, Situ, Sujian, Zhou, Suizan, Gao, Junmei, Liu, Changpeng, Zhang, Jun, Millman, Alexander J., Zhang, Tao, Tian, Jianmei, Zhao, Genming
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 22.02.2021; Elsevier Limited
• Subjects: Accounting; Caregivers; Child; Child, Preschool; Children; Children & youth; China; China - epidemiology; Clinics; Comorbidity; Confidence intervals; Cost of Illness; Costs; Direct cost; Economic burden; Economics; Hospitalization; Hospitals; Human capital; Humans; Illnesses; Immunization; Indirect cost; Influenza; Influenza, Human - epidemiology; Labor force; Laboratories; Nutrition; Outpatient care facilities; Population number; Productivity; Prospective Studies; Seasons; Surveillance; Vaccination; China; United States > US; Economic burden; Children; Indirect cost; Influenza; China; Direct cost
• ISSN: 0264-410X; 1873-2518
• DOI: 10.1016/j.vaccine.2020.12.075

•We assessed economic burden of influenza in children <5 in Suzhou from 2011-2017.•Cost per illness episode was $161 for outpatient and $1426 for hospitalization.•Annual economic burden of influenza among children <5 in Suzhou was $7.4 million.•Indirect costs accounted for 22-36% of the total annual economic burden.•Influenza in children <5 in Suzhou results in a substantial annual economic burden. Data are limited on the economic burden of seasonal influenza in China. We estimated the cost due to influenza illness among children < 5-year-old in Suzhou, China. This study adopted a societal perspective to estimate direct medical cost, direct non-medical cost, and indirect cost related to lost productivity. Data to calculate costs and rates of three influenza illness outcomes (non-medically attended, outpatient and hospitalization) were collected from prospective community-based cohort studies and hospital-based enhanced laboratory-confirmed influenza surveillance in Suzhou during the 2011/12 to 2016/17 influenza seasons. We used mean cost-per-episode, annual incidence rates of episodes of each outcome, and annual population size to estimate the total annual economic burden of influenza illnesses among children < 5-year-old for Suzhou. All costs were reported in 2017 U.S. dollars. The mean cost-per-episode (standard deviation) was $9.92 (13.26) for non-medically attended influenza, $161.05 (176.98) for influenza outpatient illnesses, and $1425.95 (603.59) for influenza hospitalizations. By applying the annual incidence rates to the population size, we estimated an annual total of 4,919 episodes of non-medically attended influenza, 21,994 influenza outpatient, and 2,633 influenza hospitalization. Total annual economic burden of influenza to society among children < 5-year-old in Suzhou was $7.37 (95% confidence interval, 6.9–7.8) million, with estimated costs for non-medically attended influenza of $49,000 (46,000–52,000), influenza outpatients $3.5 (3.3–3.8) million, and influenza hospitalizations $3.8 (3.6–3.9) million. Among outpatients, the indirect cost was 36.3% ($1.3 million) of total economic burden, accounting for 21,994 days of lost productivity annually. Among inpatients, the indirect cost was 22.1% ($829,000), accounting for 18,431 days of lost productivity annually. Our findings show that influenza in children < 5-year-oldcauses substantial societal economic burden in Suzhou, China. Assessing the potential economic benefit of increasing influenza vaccination coverage in this population is warranted.