Resource use and economic burden of respiratory syncytial virus among older adults in real-world clinical practice across five European countries

Introduction The impact of respiratory syncytial virus (RSV) is increasingly being recognized in older adults, however economic burden data is sparse. This study describes the burden of RSV and associated direct and indirect costs in adults aged 60 + years in real-world clinical practice across five European countries. Methods Data were drawn from the Adelphi RSV Disease Specific Program (DSP™), a cross-sectional survey of physicians and patients in France, Germany, Italy, Spain, and the United Kingdom conducted December 2023–June 2024. Patients aged 60 + with a confirmed RSV diagnosis were included. Physicians provided data on resource use and supportive care needs, and patients on paid and unpaid productivity loss. Country-specific unit costs were used to calculate direct and indirect costs. Patients were stratified by symptom duration from onset (acute- [A-]RSV: <4, ongoing- [O-]RSV: 4– < 12, and post-acute- [P-]RSV: 12–52 weeks) and need for hospitalization (hospitalized [H-]RSV). All analyses were descriptive. Results Physicians ( n = 682) provided data on 1,581 patients with RSV (15.0% A-RSV, 12.4% O-RSV, 37.2% P-RSV, and 35.4% H-RSV). For their current RSV infection, patients had a mean of 4.3 visits to any healthcare provider (A-RSV: 3.1–H-RSV: 4.6). H-RSV patients received nearly four times as many tests as A-RSV patients, with 54.8% receiving drugs (versus <37% in other subgroups). Overall, 87.4% of H-RSV patients stayed in hospital overnight (mean stay duration: 7.2 nights). Of all patients, 36.8% required supportive care, with 93.3–98.4% receiving non-professional care. Mean overall work impairment was 53.0% ( n = 24), with 18.0% of the 373 patients who responded reporting unpaid productivity loss. Mean direct costs per patient ranged from €320–€6,900 for A-RSV and H-RSV respectively, with hospitalization driving costs in H-RSV. Drug costs trended higher with disease duration. The indirect cost of supportive care was consistent across groups (€140–€191), meanwhile paid productive loss cost was between €52–€797 and unpaid productivity loss between €25–€415 in A-RSV and P-RSV, respectively. Conclusion RSV poses a high economic burden in older adults across disease stages, increasing numerically with symptom duration and need for hospitalization, highlighting a need for prevention and continued monitoring.