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Original Investigation
February 24, 2003

The Economic Burden of Non–Influenza-Related Viral Respiratory Tract Infection in the United States

Author Affiliations

From the Division of General Internal Medicine, Department of Internal Medicine, School of Medicine (Dr Fendrick), Departments of Health Management and Policy (Dr Fendrick) and Epidemiology (Dr Monto), School of Public Health, and the Consortium for Health Outcomes, Innovation, and Cost Effectiveness Studies (Dr Fendrick), University of Michigan, Ann Arbor; and Applied Health Outcomes, Tampa, Fla (Drs Nightengale and Sarnes). All authors serve as consultants to ViroPharma, Inc, Exton, Penn; Dr Monto has also received research funding from ViroPharma, Inc.

Arch Intern Med. 2003;163(4):487-494. doi:10.1001/archinte.163.4.487

Background  Viral respiratory tract infection (VRTI) is the most common illness in humans. Despite the high incidence, the economic impact of non–influenza-related VRTI has not been rigorously explored. Our objectives were to obtain an updated incidence of non–influenza-related VRTI in the United States and to quantify the health care resource use (direct costs) and productivity losses (indirect costs) associated with these infections.

Methods  A nationwide telephone survey of US households (N = 4051) was conducted between November 3, 2000, and February 12, 2001 to obtain a representative estimate of the self-reported incidence of non–influenza-related VRTI and related treatment patterns. Direct treatment costs measured included outpatient clinician encounters, use of over-the-counter and prescription drugs, and associated infectious complications of non–influenza-related VRTI. Absenteeism estimates for infected individuals and parents of infected children were extrapolated from National Health Interview Survey data.

Results  Of survey respondents, 72% reported a non–influenza-related VRTI within the past year. Respondents who experienced a self-reported non–influenza-related VRTI averaged 2.5 episodes annually. When these rates are extrapolated to the entire US population, approximately 500 million non–influenza-related VRTI episodes occur per year. Similarly, if the treatment patterns reported by the respondents are extended to the population, the total economic impact of non–influenza-related VRTI approaches $40 billion annually (direct costs, $17 billion per year; and indirect costs, $22.5 billion per year).

Conclusions  Largely because of the high attack rate, non–influenza-related VRTI imposes a greater economic burden than many other clinical conditions. The pending availability of effective antiviral therapies warrants increased attention be paid to this common and expensive illness.