Englische Postersession

Einleitung / Introduction

In children and adolescents, the prevalence of chronic diseases, such as obesity, asthma, and attention-deficit/hyperactivity disorder (ADHD) has increased in the last decades. These diseases are not only associated with negative effects on the young population and their families but also with a great economic burden. For children and adolescents with chronic conditions, indirect costs are likely to be high due to parents' lost workdays or missed education. However, there is no standard approach measuring and valuing productivity loss in children and ado-lescents with chronic pain. Thus, the aim of this scoping review was to get an overview of applied methods in published articles and to compare these methodological approaches and analyze benefits and shortcomings.

Methode / Method

The systematic literature search was conducted in MEDLINE and PsycINFO from inception to August 2023. Two researchers screened title, abstract, and full text independently. We includ-ed cost-of-illness studies reporting the productivity losses in children and adolescents up to 24 years with either obesity, asthma, or ADHD. Only studies published in English or German were considered. Methodological characteristics, measurement of indirect costs, cost compo-nents, data source, and costing methods were extracted.

Ergebnisse / Results

The literature search revealed 25 studies. Seventeen articles on asthma, seven on ADHD, and two on obesity were identified and thus, included in this scoping review. Most of the studies came from the United States. The largest share of the studies (52.0%) considered indirect costs by measuring and valuing caregivers’ lost work time. All of the studies included absen-teeism, but only a few studies included unpaid work (36.0%) or presenteeism (8.0%).

Zusammenfassung / Conclusion

We can conclude that there are various methodologies to consider indirect costs in children and adolescents with chronic diseases. However, differing methodologies lead to results not easy to compare. Thus, we see a strong need for scientific guidelines to perform economic evaluations focusing on children and adolescents with chronic conditions. Such guidelines will help to not only get comparable results but also to ensure that all relevant kinds of productivity loss in paid and unpaid activities, are adequately considered in future economic evaluations.

Authors

Anne Kitschen, Chair for institutional economics and health policy, department philosophy, politics and economics, Witten/Herdecke University, Witten, Germany

Lulseged Asegu, Chair for institutional economics and health policy, department philosophy, politics and economics, Witten/Herdecke University, Witten, Germany

Dirk Sauerland, Chair for institutional economics and health policy, department philosophy, politics and economics, Witten/Herdecke University, Witten, Germany

Einleitung / Introduction

Bone metastases (BM) in solid cancers are frequently causing skeletal-related events (SREs). SREs are associated with significant loss of quality of life, increased use of healthcare resources (HCRU), and substantial financial burden for healthcare systems [1,2]. This study aims to investigate the prevention of SREs and the reduction in SRE-related HCRU and associated costs between bone targeting agent (BTA)-treated and untreated patients in Germany.

Methode / Method

For this retrospective analysis data from a German sickness fund claims database spanning from 2011 to 2019 were obtained. Patients included were ≥18 years old, had a diagnosis of a primary solid cancer and bone metastasis, were observable for at least 12 months and had to be treated within 3 months after BM with BTA (BTA-treated population only). Differences in patient characteristics between BTA-treated and untreated patients were controlled for by propensity score matching. Differences between the two treatment groups were analyzed by multiple regression.

Ergebnisse / Results

After propensity score matching, the study population comprised 2268 breast, 212 kidney, 1072 lung, 1234 castration resistant prostate and 970 hormone sensitive prostate cancer patients. Patient characteristics between groups were homogenous. There was no difference observed in time-to-first SRE or number of SREs per patient year between BTA-treated and untreated patients across all tumor types and SRE types. Despite no clear trend between BTA treated and untreated patients in number of hospitalization and number of days spent in hospital per hospitalization, hospitalization costs were lower in BTA treated patients compared to untreated patients across all tumor types, except hormone-sensitive prostate cancer. A significant increase in outpatient visits as well as an increase in outpatient visit costs was observed in the BTA treated patients across all tumor types. Lower total costs per SRE were observed in BTA treated patients compared to untreated patients across all tumor types.

Zusammenfassung / Conclusion

Efficacy of BTA treatment in patients with bone metastasis from breast, prostate and other solid tumors has been clinically proven in large randomized clinical trials [3-8]. Despite no reduction in hospitalization rates and days spent in hospital, hospitalization costs were reduced for patients taking BTAs with the exception of hormone-sensitive prostate cancer. Overall, BTA treatment led to an increase in outpatient services. Lower total costs per SRE were observed in BTA treated patients compared to untreated patients across all tumor types. In light of the limitations of this German sick fund claims data analysis, the authors are unable to conclude any specific impact of BTA treatment on site of care.

Authors

Ingo Diel, Praxisklinik am Rosengarten

Hartmut Richter, Epidemiology, IQVIA

Anke Booker, Epidemiology, IQVIA

Meritxell López Canet, Amgen GmbH

Eva Schrom, Amgen GmbH

Einleitung / Introduction

Purpose: Autism Spectrum Disorder (ASD) is a developmental condition that results in lifelong impairments in social interaction, communication, and other behavioural sensitivities. The term ASD is a broad label for a range of behavioural characteristics. The objective of this research is to analyse whether the inclusion of genetic diagnostics (microarray test) is more cost-effective than the cost-effectiveness of psychometric diagnostic alone using the Early Intensive Behavioural Intervention (EIBI) treatment procedure.

Methode / Method

Methods: The authors applied a Markov model as a decision-analytic approach in their simulation. The chosen viewpoint is that of health insurance. The authors analysed the period from birth until the age of 15, with yearly cycle length. The scenarios included: The current diagnostic “status quo”, the “predisposition” scenario relating to children with genetic susceptibility and the “genetic test on request” scenario for voluntary genetic testing after birth. Parameters were determined through literature searches in Pubmed, Embase, Econlit in the period 2000 to 2022. When data were unavailable, estimates were made which means best practice.

Ergebnisse / Results

Results: The diagram illustrating the cost-effectiveness of the interventions displays a greater number of successfully treated patients in the “genetic” scenarios following EIBI. The scenarios that incorporate genetic testing exhibit better performance comparison to the “status quo” scenario. However, the predisposition scenario falls marginally below the Incremental Cost Effectivity Ratio ICER-line.

Zusammenfassung / Conclusion

Conclusion: This model provides an insight into the cost-effectiveness of the predisposition scenario. Based on current parameters, it is not feasible to incorporate an additional genetic test in the testing scenarios. The findings of this research by means of the simulation and the application of the Markov model should be considered with care given the sensitivity analyses, which do not support the cost-effectiveness results. Enhanced genetic diagnostics in the future are expected to result in greater effectiveness, which could potentially alter the decision to adopt routine use.

Authors

Wolfgang Rudolph-Rothfeld

Einleitung / Introduction

Loneliness is related to serious diseases, such as cardiovascular diseases (CVD), diabetes, anxiety, depression, or dementia and can lead to more suicides according to WHO. Globally, one third of adults feels lonely. However, the economic burden remains uncertain. In Spain, the aging population, changing social dynamics, and the COVID-19 pandemic increased loneliness. Given the known health impacts of loneliness, our study aims to assess health-related costs of loneliness and the potential impact of a nature-based intervention (NBI) for loneliness alleviation on the costs in Spain within the framework of the Horizon 2020 project RECETAS (No 945095).

Methode / Method

We conducted a systematic literature review in PubMed complemented by manual searches to identify cost-of-illness studies using MeSH terms, such as “Costs and Cost Analysis” and “Cost of Illness” for loneliness-related health consequences. Title and abstract followed by full-text screening was performed by one researcher. Relevant study characteristics, such as disease, study population, total costs, if available, direct (non-) medical and indirect costs, time frame, price year, perspective, and limitations were summarized in a systematic data extraction table. For each disease, we selected one study from a Spanish societal perspective fitting best our overall research questions in the RECETAS project for further calculations. Costs were converted into 2022 EUR using the consumer price index. Intervention costs were derived from an outdoor activity program conducted in Wales. Total NBI costs were calculated by multiplying costs per treated person by the prevalence of lonely adults in Spain.

Ergebnisse / Results

17 studies for dementia, seven for CVD, six for diabetes, five for depression, three for anxiety, and two for suicide were identified. There was substantial heterogeneity in all study characteristics. For example, price unit was reported per patient, per capita or in total. The selected studies reported annual average costs per patient of EUR 30,029 for dementia, 23,241 for heart failure, 3,320 for diabetes, 10,459 for anxiety, 3,891 for depression, and 727 per suicide death. If all lonely people in Spain (4,898,355) would utilize loneliness-alleviating interventions, total costs for the program would add up to EUR 3.16 billion assuming program costs per participant of EUR 645. A NBI could be cost saving if, for example, more than 812,000 people could be prevented from depression or 105,000 people from dementia for at least one year.

Zusammenfassung / Conclusion

A NBI has the potential to reduce costs for the Spanish population suffering from loneliness. However, a full health-economic evaluation including the cost of NBIs as well as epidemiological and quality-of-life data is needed to assess the long-term impacts and cost effectiveness of NBIs.

Authors

Veronika Papon, UMIT TIROL

Sibylle Puntscher, UMIT TIROL

Marjan Arvandi, UMIT TIROL

Beate Jahn, UMIT TIROL

Laura Coll-Planas, Uvic-UCC

Jill S. Litt, ISGlobal

Uwe Siebert, UMIT TIROL

Ursula Rochau, UMIT TIROL

Einleitung / Introduction

The 13-valent pneumococcal conjugate vaccine (PCV13) has been included by Germany’s Standing Committee on Vaccinations as a standard vaccination (SoC) for infants in 2009, resulting in major reductions in pneumococcal disease (PD). Higher-valent vaccines may further reduce PD burden. This cost-effectiveness analysis estimated costs and health benefits of PCV20 compared to PCV15 and PCV13 in Germany’s pediatric population.

Methode / Method

A Markov model with annual cycles over a 10-year time horizon was adapted to simulate the clinical and economic consequences to the German population and compare pediatric vaccination with PCV20 to lower-valent PCVs. The model used PCV13 clinical effectiveness and impact studies as well as PCV7 efficacy studies for vaccine direct and indirect effect estimates. Epidemiologic, utility, and medical cost inputs were obtained from published sources. Benefits and costs were discounted at 3% from a German societal perspective. Outcomes included PD cases, deaths, costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs).

Ergebnisse / Results

In the base case, PCV20 provided greater health benefits than SoC, averting more cases of invasive pneumococcal disease (IPD; 15,301, hospitalized and non-hospitalized pneumonia (460,197 and 472,365, respectively), otitis media (531,634), and 59,265 deaths over 10-years. This resulted in 904,854 additional QALYs and a total cost-saving of €2,393,263,611, making PCV20 a dominant strategy compared with PCV13. Compared to PCV15, PCV20 was estimated to avert an additional 11,334 IPD, 704,948 pneumonia, and 441,643 otitis media cases, as well as 41,596 deaths. PCV20 was associated with a higher QALY gain and lower cost (i.e., dominance) compared with PCV15. The robustness of the results was confirmed through scenario analyses as well as deterministic and probabilistic sensitivity analyses.

Zusammenfassung / Conclusion

PCV20 dominated both PCV13 and PCV15 over the model time horizon. Replacing lower-valent PCVs with PCV20 would result in greater clinical and economic benefits, given PCV20’s substantial broader serotype coverage.

Authors

An Ta, Cytel

Felicitas Kühne, Pfizer Pharma GmbH

Maren Laurenz, Pfizer Pharma GmbH

Christof von Eiff, Pfizer Pharma GmbH

Sophie Warren, Pfizer Inc

Johnna Perdrizet, Pfizer Canada

Einleitung / Introduction

Public health practitioners require an ethical framework specific to public health. However, there is no consensus on such a framework in the literature. While a number of systematic comparisons and reviews of public health ethics frameworks have been conducted in recent years, little work to date has focused on comparing the substantive conditions these frameworks apply to public health measures. Our aim is to fill this gap in the literature by (1) providing a comprehensive overview of the substantive conditions included in public health ethics frameworks and (2) identifying and discussing open questions and disagreements concerning the definition and application of these substantive conditions.

Methode / Method

We reviewed the literature to identify public health ethics frameworks that include substantive conditions for public health measures. Subsequently, we identified and discussed open questions arising from disagreements between these frameworks, focusing particularly on four substantive conditions that are included in nearly all public health ethics frameworks: effectiveness, necessity, least infringement/burden minimization, and proportionality.

Ergebnisse / Results

Although most frameworks included effectiveness, necessity, least infringement, and proportionality as substantive conditions for public health measures, we identified a number of open questions concerning their exact definition and application. Concerning the effectiveness condition, these include the role of feasibility and of theory-based arguments. For the necessity and least infringement/burden minimization conditions, open questions remain concerning the process of comparing alternative measures, the burden of moral proof and the exact nature of the relationship between these two conditions. Further, we identified open questions regarding what role fair procedures should play in assessing a measure’s proportionality and whether proportionality should be assessed on a moral spectrum, rather than as a binary condition. Finally, we identified a number of overarching open questions, including the order in which substantive conditions should be applied and the possible inclusion of additional substantive conditions based on cost-effectiveness or other values, such as distributive justice and autonomy.

Zusammenfassung / Conclusion

There is no shortage of public health ethics frameworks in the literature. However, our results show that significant points of contention remain concerning which substantive conditions these frameworks should include, how these conditions should be defined, and in which order they should be applied. Further research is needed to address these open questions and to work towards a consensus framework for public health ethics.

Authors

John Grosser, Universität Bielefeld, Fakultät für Gesundheitswissenschaften, Arbeitsgruppe für Gesundheitsökonomie und Gesundheitsmanagement

Hanna Rehse, Universität Bielefeld, Fakultät für Gesundheitswissenschaften, Arbeitsgruppe für Gesundheitsökonomie und Gesundheitsmanagement

Birthe Aufenberg, Universität Bielefeld, Fakultät für Gesundheitswissenschaften, Arbeitsgruppe für Gesundheitsökonomie und Gesundheitsmanagement

Lena Hasemann, Universität Bielefeld, Fakultät für Gesundheitswissenschaften, Arbeitsgruppe für Gesundheitsökonomie und Gesundheitsmanagement

Juliane Düvel, Universität Bielefeld, Fakultät für Gesundheitswissenschaften, Arbeitsgruppe für Gesundheitsökonomie und Gesundheitsmanagement

Einleitung / Introduction

In Germany, anthropogenic climate change results in a higher likelihood of extreme temperature events. Coupled with the country’s aging society, this is set to effect dire health consequences with strong health economic implications. A detailed understanding of the association of temperature and population health is therefore critical to mitigate negative effects and increase healthcare system resilience. In this observational study, we aimed to quantify the immediate and lagged effects of extreme ambient temperature on the morbidity, case severity and costs in German emergency care.

Methode / Method

We merged the Diagnostic Related Group (DRG) Statistic of the German Federal Statistical Office containing anonymized information on all emergency admissions (EAs) to German hospitals between 2010 and 2019 with daily measurements of weather stations of the German Meteorological Service. Besides the EA rate as a measure of morbidity and EA mortality rate as a measure of case severity, we investigated the average length of stay (LOS) of EAs. Contrasting to mortality, LOS is a more continuous proxy of case severity. Further, EA cost rates were calculated from the payers' perspective. All outcome rates were calculated per day, county and 100.000 inhabitants. Days classified into temperature bins, where extreme heat and cold days were defined as a maximum temperature > 30°C and a minimum temperature < -5°C, respectively. As a non-extreme reference, we chose days with temperatures between 5 and 15°C. For inferential analyses, we used fixed effects models with lagged indicators for extreme heat and cold for the 30 days prior to admission.

Ergebnisse / Results

Our sample contained 78,486,368 EAs. On average, we classified 19.9 days as cold days and 11.6 days as heat days per county per year. Heat on the day of admission was associated with a higher mean EA rate (β=0.92, p<0.001), a higher EA mortality rate (β=0.06, p<0.001), and a higher EA cost rate (β=-3073.84€, p<0.001), but a shorter LOS (β=-0.09, p<0.001). In contrast, extreme cold on the day of admission was associated with a lower EA rate (β= -0.89, p<0.001), a shorter LOS (β=-0.03, p=0.007), a lower EA cost rate (β=-2132.50€, p<0.001), but not with the EA mortality rate (β=-0.00, p=0.997). The analysis of lagged temperature effects indicated that heat affects morbidity, case severity and costs both immediately and over the course of several days. The effect of cold only emerged after several days and continued beyond a week. A “harvesting” effect was only evident for the effect of heat on EA mortality.

Zusammenfassung / Conclusion

This study provides a better understanding of the effects of ambient temperature on disease burden, case severity and costs in emergency care at the backdrop of climate change. Findings emphasize the necessity of mitigating measures.

Authors

Jona Frasch, Universitätsklinikum Hamburg-Eppendorf

Hans-Helmut König, Universitätsklinikum Hamburg-Eppendorf

Claudia Konnopka, Universitätsklinikum Hamburg-Eppendorf

Einleitung / Introduction

Acute respiratory infection (ARI) caused by respiratory syncytial virus (RSV) causes a substantial burden on health systems and negatively affects health-related quality of life (HRQoL). Older adults as well as immunocompromised patients are at particular risk of severe outcomes due to RSV infection. The aim of this analyses was to estimate the impact of an RSV infection on the costs and HRQoL in patients ≥60 years of age in the outpatient setting in Germany.

Methode / Method

“Burden of Disease and Cost of illness for RSV and other pathogens in patients 60 years and older within the outpatient setting (BUCOSS)” is an observational, multicentre, prospective, active surveillance study. ARI patients were enrolled in 16 practices in the outpatient setting and were tested for viral pathogens by using multiplex-PCR diagnostic. During the first study season 2022/2023, direct medical costs, direct non-medical costs (out-of-pocket costs) and indirect costs were determined in patients with confirmed RSV-infection. HRQoL was assessed by the EQ-5D-5L questionnaire at the first visit (Day 0), followed by Day 14 and, if not fully recovered, Day 28. Additionally, the results were mapped from the EQ-5D-5L version to the EQ-5D-3L version. A subgroup analysis for lower (LRTI) and upper respiratory tract infection (URTI) was conducted.

Ergebnisse / Results

Out of 409 ARI patients, 53 patients treated in the outpatient setting with confirmed RSV were included in the analyses, whereas 32 had LRTI and 21 had URTI. On Day 0, mean overall HRQoL was 0.82 and increased on Day 14 (0.93) and 28 (0.97), with lower values in patients with LTRI (D0: 0.78, D14: 0.90, D28: 0.97) than UTRI (D0: 0.88, D14: 0.97, D28: 0.98). For the whole study population, mean costs of 32.55€ (LTRI 32.30€, URTI 32.92€) were incurred for office visits, 33.90€ (LTRI 44.23€, URTI 18.17€) for medications and 3.93€ (LTRI 6.19€, URTI 0.50€) for laboratory and other services. Out of pocked costs were: 8.37€ (LTRI 12.45€, URTI 2.16€) for travel expenses, 5.25€ (LTRI 6.81€, URTI 2.86€) for co-payments for prescribed medication and 8.06€ (LRTI: 8.97€, URTI: 6.67€) for over-the-counter medication. In the working study population (N = 14), the mean indirect costs resulted in 383.3€, which were driven by an average of 18.1 working hours lost, with no differentiation between URTI and LTRI due to small numbers of active working patients in each subpopulation.

Zusammenfassung / Conclusion

Our data show a substantial reduction in HRQoL during RSV infection in the outpatient setting which is more strongly reduced in patients with LTRI than with URTI and improves gradually over time. There is an observed difference between the economic burden and HRQoL between LTRI and URTI with the need for further exploration.

Authors

Christopher Hinze, Department of Respiratory Medicine and Infectious Diseases, Hannover Medical School, Hannover, Germany.

Frank Eberhardt, CAPNETZ STIFTUNG, Hannover, Germany.

Laura Grebe, CAPNETZ STIFTUNG, Hannover, Germany.

Rachel Reeves, GSK, Brentford, United Kingdom

Pavo Marijic, GSK, Munich, Germany

Eliazar Sabater Cabrera, GSK, Wavre, Belgium

Alen Marijam, GSK, Wavre, Belgium

Paul Schmidt, Statistical Consulting for Science and Research, Berlin, Germany

Roland Diel, Institute for Epidemiology, University Hospital Schleswig Holstein, Kiel, Germany.

Gernot Rohde, Goethe University Frankfurt, University Hospital, Medical Clinic I, Department of Respiratory Medicine, Frankfurt/Main, Germany.

Einleitung / Introduction

Activity involvement is a central element of dementia care. However, few studies have examined preferences for types of activities for persons who may be in need of care in the future. In this study, a Best-Worst-Scaling (BWS) experiment was conducted to gather insights on preferred activities in small-scale living arrangements for dementia in the general population aged 50 to 65 years from rural and urban regions in Germany.

Methode / Method

BWS tasks were developed based on literature searches and focus groups. The final BWS contains ten activities, namely ‘interaction with animals’, ‘gardening’, ‘painting, handicrafts, manual activities’, ‘household activities (e.g., folding laundry, cooking)’, ‘watching television’, ‘practicing religion’, ‘listening to music and singing familiar songs’, ‘conversations about the past’, ‘walks and excursions’, ‘sport activities (e.g., gymnastics)’. Each participant had to fill out subsets of four objects each and identify them as best and worst. Individuals from the general population between the ages of 50 and 65 were identified through population registration offices in three rural communities and an urban area, and 4,390 persons were approached via postal survey. Results were analyzed by count analysis and logit models. It was examined if preferences differ with respect to gender, religiousness, and informal caregiving experience.

Ergebnisse / Results

A total of 840 questionnaires were returned, and 627 surveys were included in the analysis. In the rural sample, the highest relative importance (RI) was assigned to ‘walks and excursions’ (RI: 100%), ‘sport activities (e.g., gymnastics)’ (RI: 56%), ‘gardening’ (RI: 28%), and ‘interaction with animals’ (26%). In the urban sample, ‘walks and excursions’ (RI: 100%), ‘sport activities (e.g., gymnastics)’ (RI: 37%), ‘interaction with animals’ (25%) and ‘gardening’ (RI: 22%) were perceived as most important. In both groups, household activities and practicing religion were of lowest importance. Importance ranks differed between subgroups. Results of the logit models with random effects showed the same order as results from the count analyses.

Zusammenfassung / Conclusion

Our findings show that respondents generally favored activities with an outdoor component, while the household activities that are part of many concepts were of low importance to respondents. By considering subgroup-specific activity preferences, our findings can contribute to the development of preference-based care for persons with dementia.

Authors

Christian Speckemeier, Lehrstuhl für Medizinmanagement, Universität Duisburg-Essen

Carina Abels, Lehrstuhl für Medizinmanagement, Universität Duisburg-Essen

Klemens Höfer, Lehrstuhl für Medizinmanagement, Universität Duisburg-Essen

Anke Walendzik, Lehrstuhl für Medizinmanagement, Universität Duisburg-Essen

Jürgen Wasem, Lehrstuhl für Medizinmanagement, Universität Duisburg-Essen

Silke Neusser, Lehrstuhl für Medizinmanagement, Universität Duisburg-Essen

Einleitung / Introduction

Acute respiratory infections (ARI) caused by respiratory syncytial virus (RSV) represent a high health and economic burden in people aged ≥ 60 years. As evidence on the impact of RSV in Germany is limited, the primary goal of this study was to investigate RSV-related costs, health care resource utilization (HCRU) and complications in older adults.

Methode / Method

Using health insurance data from 2010 to 2019 from the WIG2 database of about 4.5 million persons, patients ≥ 60 years of age were selected and assigned to three nested cohorts using ICD-10 codes: RSV, RSV-possible (including RSV) and ARI (including RSV-possible). Patients from each cohort were 1:1 matched to a control group without the respective infections, using a combination of exact and propensity score matching. Hospitalizations were identified with a primary hospitalization diagnosis. Excess costs and HCRU for outpatient treatments and medications, and excess complications rates were calculated over two quarters. Subgroup analyses for lower respiratory tract infections (LRTI) and upper respiratory tract infections (URTI) were performed, while only LRTI-specific diagnoses were available for RSV.

Ergebnisse / Results

We matched 862 RSV cases, 1,085,070 RSV-possible cases and 1,293,574 ARI cases to control patients. A significant increase in outpatient physician costs of 116€ for RSV, 61€ (URTI: 59€, LRTI: 66€) for RSV-possible and 63€ (URTI: 60€, LRTI: 69€) for ARI and a significant increase in physician contacts of 2.0, 1.3 (URTI: 1.1, LRTI: 1.7), and 1.4 (URTI: 1.1, LRTI: 1.8) per infection was observed. Medication costs were significantly increased with 16€ for RSV, 14€ (URTI: 10€, LRTI: 19€) for RSV-possible and 14€ (URTI: 11€, LRTI: 18€) for ARI. Hospital costs due to RSV were 5,553€, RSV-possible-LRTI 3,601€ and ARI-LRTI 4,202€. Excess complications occurred significantly more often in all three cohorts presenting as pneumonia (RSV: 32%, RSV-possible-LRTI: 27%, ARI-LRTI: 34%), acute respiratory distress syndrome (ARDS) (RSV: 22%, RSV-possible-LRTI: 8%, ARI-LRTI: 12%), and hospitalization for congestive heart failure (CHF) (RSV: 3%, RSV-possible-LRTI: 4%, ARI-LRTI: 5%). No excess complications of pneumonia, ARDS and CHF were observed in URTI infections. Additional exacerbations were present in COPD patients (RSV: 31%, RSV-possible-LRTI: 30%, RSV-possible-URTI: 15%, ARI-LRTI: 32%, ARI-URTI: 16%) and in asthma patients (RSV: 13%, RSV-possible-LRTI: 5%, RSV-possible URTI: 2%, ARI-LRTI: 5%, ARI-URTI: 2%).

Zusammenfassung / Conclusion

RSV infections are associated with a high economic burden, especially in the hospital setting. RSV and ARI-related complications are common in the elderly. Additionally, RSV is highly underrepresented in claims data and mostly non-specific pathogen diagnoses are present.

Authors

Pavo Marijic, GSK, Munich, Germany

Roman Kliemt, WIG2 Scientific Institute for Health Economics and Health System Research, Leipzig, Germany

Martin Krammer, GSK, Munich, Germany

Nikolaus Kolb, ZEG Berlin – Center for Epidemiology and Health Research, Berlin, Germany

Theo Last, GSK, Wavre, Belgium

Maria Waize, GSK, Munich, Germany

Manuela Stierl, GSK, Munich, Germany

Maria João Fonseca, GSK, Lisbon, Portugal

Alen Marijam, GSK, Wavre, Belgium