Healthcare costs related to respiratory syncytial virus in paediatric intensive care units in the Netherlands: a nationwide prospective observational study (the BRICK study)

Emily W E M Phijffer; Joanne G Wildenbeest; Carole N M Brouwer; Matthijs de Hoog; Martin C J Kneyber; Sofie Maebe; Anneliese Nusmeier; Maaike A Riedijk; Roelie M Wösten-van Asperen; Job B M van Woensel; Louis J Bont; Geert J W Frederix

doi:10.1016/j.lanepe.2024.100965

Healthcare costs related to respiratory syncytial virus in paediatric intensive care units in the Netherlands: a nationwide prospective observational study (the BRICK study)

Lancet Reg Health Eur. 2024 Jun 26:43:100965. doi: 10.1016/j.lanepe.2024.100965. eCollection 2024 Aug.

Affiliations

¹ Department of Paediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands.
² Paediatric Intensive Care Unit, Leiden University Medical Centre, Leiden, the Netherlands.
³ Division of Paediatric Intensive Care, Department of Neonatal & Paediatric Intensive Care, Erasmus MC - Sophia Children's Hospital, Rotterdam, the Netherlands.
⁴ Division of Paediatric Critical Care Medicine, Department of Paediatrics, Beatrix Children's Hospital, University Medical Centre Groningen, Groningen, the Netherlands.
⁵ Paediatric Intensive Care Unit, Maastricht University Medical Centre, Maastricht, the Netherlands.
⁶ Paediatric Intensive Care Unit, Amalia Children's Hospital, Radboud University Medical Centre, Nijmegen, the Netherlands.
⁷ Paediatric Intensive Care Unit, Emma Children's Hospital, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands.
⁸ Paediatric Intensive Care Unit, Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands.
⁹ Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands.

Abstract

Background: The implementation of the approved respiratory syncytial virus (RSV) preventive interventions in immunisation programmes is advancing rapidly. Insight into healthcare costs of RSV-related paediatric intensive care unit (PICU) admissions is lacking, but of great importance to evaluate the impact of implementation. Therefore, this study aimed to determine the total annual RSV-related paediatric intensive care healthcare costs in the Netherlands.

Methods: A nationwide prospective, observational, multicenter study was performed from September 2021 until June 2023. The total annual RSV-related healthcare costs on PICUs in the Netherlands were calculated using RSV-related costs (subgroup I) and consequential costs (subgroup II and III). Subgroup I comprised all PICU admitted infants ≤12 months of age with laboratory-confirmed RSV infection. Subgroup II and III consisted of postponed elective PICU admissions and refused acute PICU admissions due to RSV-related lack of PICU capacity.

Findings: A total of 424 infants with RSV-related PICU admission were included. Median age at PICU admission was 46 days (IQR 25-89). The median length of PICU admission was 5 days (IQR 3-8). The total RSV-related PICU costs are € 3,826,386 in 2021-2022, and € 3,183,888 in 2022-2023. Potential costs averted by RSV preventive interventions is € 1.9 to € 2.6 million depending on season, and the duration of protection.

Interpretation: RSV-related PICU admissions cost €3.1 to €3.8 million in the Netherlands during one season. The introduction of new RSV preventive interventions into the Dutch immunisation programme will generate significant cost-savings on PICUs and decreases the admission burden of PICUs.

Funding: None.

Keywords: Cost of illness; Critical care; Healthcare costs; Respiratory syncytial viruses; Tertiary care centers.