Goldstein et al: Increased risk of RSV hospitalization in the 2014-2016 seasons vs the 2012-2014 seasons1,2

A study examining risk of RSV hospitalization in preterm infants in the 2014-2016 and 2012-2014 RSV seasons

Study Design

Data Source

MarketScan Commercial Claims and Multistate Medicaid databases

Patient Selection Criteria

Infants <1 year CA between July 1, 2011, and June 30, 2016

Included

  • Preterm infants born 29-34 wGA
  • Full-term infants without health problems

Commercially insured infants born 29-34 wGA, n=33,667

Commercially insured infants born full term, n=668,619

Medicaid-insured infants born 29-34 wGA, n=51,439

Medicaid-insured infants born full term, n=908,594

Excluded

  • Preterm and full-term infants with CLDP, CHD, or other special conditions, such as: Cystic fibrosis Immunodeficiency Congenital anomalies of respiratory system Neuromuscular, immunological, or genetic conditions Organ transplants

Outcomes Evaluated

  • RSV hospitalizations were examined using ICD-9-CM and ICD-10-CM codes
  • ICD-9-CM CODES

  • RSV infection (079.6)
  • RSV bronchiolitis (466.11)
  • RSV pneumonia (480.1)
  • ICD-10-CM CODES

  • RSV as the cause of diseases classified elsewhere (B974 and J205)
  • RSV pneumonia (J121)
  • Acute bronchiolitis due to RSV (J210)
  • Rate ratios were defined as preterm infant risk relative to full-term infant risk

Study Limitations

  • RSV hospitalizations were identified using ICD-9-CM and ICD-10-CM diagnosis codes on inpatient claims; confirmatory laboratory results were not available

Risk of RSV Hospitalization

When compared to full-term infants, the risk of RSV hospitalization was significantly greater in commercially insured preterm infants 29-34 wGA and <6 months CA in the 2014-2016 seasons vs the 2012-2014 seasons

  
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Graph showing number of RSV-related hospitalizations among commercially-insured infants by gestational age and RSV season (2013-2014 vs. 2014-2015). 

When compared to full-term infants, the risk of RSV hospitalization was significantly greater in Medicaid-insured preterm infants 29-34 wGA and <6 months CA in the 2014-2016 seasons vs the 2012-2014 seasons

  
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Graph showing number of RSV-related hospitalizations among commercially-insured infants by gestational age and RSV season (2010-2014 vs 2014-2015). 

Summary

Goldstein et al conclusions:

  • When compared to full-term infants, the risk of RSV hospitalization was significantly greater in commercially insured and Medicaid-insured preterm infants 29-34 wGA and <6 months CA in the 2014-2016 seasons vs the 2012-2014 seasons
  • 2x greater in commercially insured infants
  • 1.5x greater in Medicaid-insured infants

References

  1. Goldstein M, Krilov LR, Fergie J, et al. Poster presented at: Academy of Managed Care Pharmacy Nexus; October 16-19, 2017; Dallas, TX.
  2. Data on file, REF-23618, AstraZeneca Pharmaceuticals LP.

RSV=respiratory syncytial virus; CA=chronological age; wGA=weeks gestational age; CLDP=chronic lung disease of prematurity; CHD=congenital heart disease; CI=confidence interval.