The Burden of Respiratory Syncytial Virus: Understanding Impacts on the NHS, Society and Economy

Short abstract

Respiratory syncytial virus (RSV) is a significant burden on the healthcare system and on children and their parents and caregivers. We estimate RSV in children under 5 in the UK costs £80 million each year: £14 million of productivity losses, £1.5 million of out-of-pocket expenses for parents/carers, and £65 million of healthcare costs.

Abstract

Respiratory syncytial virus (RSV) is a common respiratory virus that affects large numbers, mainly of children younger than five. The burden of RSV includes not only ill health for the children with the virus, which in severe cases results in hospitalisation, intensive care and even death; but also the emotional and practical burden on the affected families and carers; and the impact that has on productivity in the economy; alongside the costs of providing healthcare.

We reviewed recent literature and published data relevant to the UK and used this information to model the costs to the healthcare system and to the wider UK economy in terms of productivity losses of parents/carers. We found healthcare costs and productivity losses in the UK resulting from RSV in children younger than five total approximately £80 million annually. These costs are the consequence, in part, of an estimated 467,000 GP visits per year in the UK for children aged under five with RSV and 34,000 hospitalisations.

Our study also presents additional material, identified in the literature review, on the health impacts on affected children and the nature of the burden on parents and families of caring for a young child with RSV. The consequences of RSV are short-term for the majority of cases, but for some there are long term sequelae including poorer respiratory health in later life. RSV is also responsible for the deaths each year in the UK of an estimated 33 children under five.

This study describes and quantifies where possible, the UK burden of Respiratory Syncytial Virus (RSV) in children aged up to five, their families and carers, and the healthcare system and economy. RSV is a common virus prevalent among infants and young children that causes acute lower respiratory tract infections such as pneumonia and bronchiolitis.

The evidence presented here is from a recent literature review (29 papers) and published data relevant to the UK. Both sources informed our economic model, which estimates the costs to the National Health Service (NHS) and the wider costs in terms of productivity losses of parents/carers. Costs are expressed in 2020/21-financial-year price terms and estimated from UK data for 2019 (the last pre-COVID-19 pandemic year) that approximated £80 million in annual healthcare costs and productivity losses to the economy from RSV in children younger than five. This figure is equivalent to a mean total cost per child below five presenting to the NHS with RSV of £97. Just over £14 million of the £80 million annual cost is due to productivity losses, about £1.5 million to out-of-pocket costs incurred by parents/carers, and the remaining nearly £65 million to healthcare costs. The estimated costs are the consequence, in part, of an estimated 467,230 General Practice (GP) visits and 33,937 hospitalisations per year in the UK for children aged under five with RSV.

Based on our modelling, the number of deaths of children aged up to five attributable to RSV is relatively small but still amounts to an estimated 33 per year in the UK. Although the healthcare consequences of RSV are short-term for the majority of cases, there are long term sequelae for some, including poorer respiratory health in later life.

Infants aged 0–6 months represent about 10% of the total population of children under five yet account for 33% of the total annual cost estimate. Children in the first six months of their lives are responsible for nearly half of the hospitalisation costs (including outpatient costs) of RSV cases in children under five in the UK, including outpatient costs. We estimate that children aged 0–12 months incur 49% of the total annual cost of RSV in children under five. We conclude that RSV has a much larger burden on infants during their first year of life than any subsequent age.

Our modelling also illustrates that although babies born prematurely account for 19% of the total RSV cost burden, the RSV cost burden of babies born at term totals more than four times as much (though the cost per child is much less). When considering the cost burden of RSV, it would be a mistake to focus primarily on pre-term infants.