New findings from a recent white paper highlight the economic and healthcare burden posed by Respiratory Syncytial Virus (RSV) on at-risk older adults aged 60 years or over in select high-income APEC countries and regions,including Australia,Hong Kong,Japan,and Singapore

Singapore had 3,251 estimated RSV hospitalisations in 2023,with hospitalisation costs per person amounting to SGD 9,430 (USD 7,037),amongst the highest in the region as compared to Australia at SGD 7,757 (USD 5,789) and Japan at SGD 8,242 (USD 6,151); Hong Kong had a slightly higher cost at SGD 7,848 (USD 10,515)

Older adults aged 60 years or over with comorbidities such as chronic obstructive pulmonary disease (COPD),immune decline,and respiratory conditions,as well as those living in long-term care facilities,face higher risk of RSV infection,and higher RSV-associated estimated hospitalisation costs due to extended hospital stays,intensive care and emergency visits

SINGAPORE,March 11,2025 -- A newly released white paper,based on research conducted independently byIQVIA,a global healthcare consultancy,and commissioned by GSK,highlighted the economic and healthcare burden posed by Respiratory Syncytial Virus (RSV) on older adults aged 60 years or over in high-income Asia-Pacific Economic Cooperation (APEC) countries and regions,and Singapore.

Substantial RSV-associated Hospitalisation Costs Put Pressure on Older Adults

The white paper estimated that in 2023,RSV led to approximately 3,251 hospitalisations amongst older adults in Singapore and is linked to a higher per-person direct medical cost (compared to cost in Australia and Japan) to cover inpatient stays,increased hospitalisation length,ICU resources,and emergency visits.2

Amongst the APEC countries and regions in the survey,hospitalisation costs per older adult in Singapore amounted to SGD 9,* as compared to Australia at SGD 7,789)* and Japan at SGD 8,151).* Hong Kong had a slightly higher cost at SGD 7,515)* compared to Singapore's.

RSV,a common and contagious virus that affects the lungs and respiratory airways,that can affect people of all ages,from infants to adults. Among adults,it disproportionately affects older adults with weakened immunity and pre-existing chronic conditions. As older adults aged 60 years or over experience a weaker immune system,they are more susceptible to severe RSV infections. Chronic conditions,such as heart diseases,asthma,and chronic obstructive pulmonary disease (COPD),are factors that could exacerbate the impact of RSV,leading to health decline,re-hospitalisations,and loss of independence even after the acute episode has resolved.3-6

A four-year study conducted in Singapore reported that one in every 20 older adults aged 65 years or over has tested positive for RSV in influenza-negative specimens.7

A family member caregiver of an RSV patient (name withheld on the caregiver's request) interviewed by GSK,shared,"As a caregiver,watching a loved one struggle with RSV is incredibly challenging. The challenge goes beyond the illness itself — it is the sleepless nights,the constant worry,and the disruption to daily life. When my mother was hospitalised due to RSV,I realised how vulnerable we all are to this virus. The financial strain is just as overwhelming as the emotional toll. Hospital bills,medication costs,and the possibility of long-term care can quickly add up,leaving families financially drained on top of the stress of caring for a loved one. Speak to your doctor early when in doubt to avoid unnecessary hospital stays and the added financial burden."

Burden of RSV Hospitalisation Amongst Older Adults with Chronic Conditions Highlight Need for Increased Awareness and Improved Diagnosis

Earlier published studies have reported that the direct medical cost associated with RSV hospitalisation rose significantly for patients with more severe outcomes,which were more frequently observed in older adults,especially those with pre-existing chronic conditions.8-10

More than 85% of Singaporean adults aged 60 years or over have reported having been diagnosed with at least one chronic condition,11 and it has been estimated that nearly 25% of the Singapore population will be 65 years of age or older in 2030,compared to the current 14%.12

Dr Lee Tau Hong,Infectious Disease Specialist,Infectious Diseases Care Clinic in Singapore,shared with GSK,"RSV poses a significant burden on patients,families,and healthcare systems worldwide. It not only causes distress for patients but also places immense strain on resources during peak flu and RSV seasons. Addressing this burden through prevention,early detection,and education is critical to safeguarding public health and reducing the impact of RSV on our communities."

The Way Forward

IQVIA's white paper underscores the importance of preventive measures,such as RSV vaccination programmes,to mitigate the virus's impact on older adults and alleviate the strain on healthcare resources.

Other preventive measures,beyond vaccination,include practicing good hygiene by covering coughs and sneezes and ensuring ample physical distance away from others when one is sick.13

Additionally,the white paper highlighted the value of increasing the frequency of testing to identify RSV cases in implementing effective healthcare strategies. Further,the white paper brought out the importance of accurate information as a first step towards preventing RSV infections and the role of healthcare professionals in engaging with the public.

"Low awareness of RSV and preventive actions,coupled with the reported substantial costs of medical treatment and hospitalisation,presents a significant financial burden,especially amongst older adults. It is important to also understand that older adults who come out of hospitalisation due to severe RSV could experience significant changes in the quality of their lives,with some sharing that they were never the same person again. This highlights the urgent need to address the growing impact of RSV infections on healthcare systems and strengthen primary,acute,and long-term care in societies where ageing is an emerging challenge,such as Singapore,shared Dr. Stephanie Cinthu Stephen Ambrose,Country Medical Director,GSK Singapore.

The IQVIA white paper concluded emphasising on the need for healthcare practitioners,public health bodies,and policymakers to come together to improve RSV patient outcomes in APEC countries,including Singapore,and prevent RSV infection in older adults.

The full white paper,"Economic Burden of Respiratory Syncytial Virus (RSV) Infection Among OlderAdults in Select Asia-Pacific Economic Cooperation (APEC) Countries," can be accessed via https://www.iqvia.com/locations/asia-pacific/library/white-papers/economic-burden-of-respiratory-syncytial-virus-infection-among-older-adults.

*IQVIA white paper reported costs in USD currency; conversion to SGD utilised the prevailing rate at the time of writing

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Representation of the respiratory syncytial virus (RSV Virus) (owned by GSK)

About RSV in older adults aged 60 years or over

RSV is a common contagious virus affecting the lungs and breathing passages that can affect people of all ages,from infants to adults. For adults 60 and older,data suggest an increased risk for severe RSV infection that can lead to hospitalisation.15Older adults are at high risk for severe disease due in part to age-related decline in immunity,and older adults with underlying conditions are at even greater risk for severe disease15. RSV can exacerbate conditions,including chronic obstructive pulmonary disease (COPD)16,asthma17,diabetes18 and congestive heart failure19 and can lead to severe outcomes,such as pneumonia,hospitalisation,and death15.

About GSK

GSK is a global biopharma company with a purpose to unite science,technology,and talent to get ahead of disease together. Find out more at https://www.gsk.com/en-gb/locations/singapore/

About the IQVIA White Paper

The IQVIA white paper has been developed independently by the IQVIA RWE Medical and Scientific Writing: Epidemiology and Database Studies team. Funding for this work has been provided by GSK. Editorial assistance was provided by Shlok Kumar,Consultant,IQVIA,India.

A Pragmatic Literature Review (PLR) was conducted to identify published evidence on Respiratory Syncytial Virus (RSV) hospitalization incidence,number,and cost in adults,with a defined scope,inclusion criteria,and data identification and extraction methods. Once the criteria were defined,they were converted into strategies,which were then used to search relevant databases for identifying pertinent evidence. The selected articles were assessed according to the established inclusion and exclusion criteria.

References

1. Costs are adjusted for inflation till 2023. The local Singapore currency was converted from United States dollars (USD) based on the exchange rate of 2023 on World Bank. Available from: https://data.worldbank.org/indicator/PA.NUS.FCRF?locatiG.

2. Branche AR,Falsey AR. Respiratory Syncytial Virus infection in older adults: an under-recognized problem. Drugs Aging. 2015;32(4):261-9.

3. Mehta J,Walsh EE,Mahadevia PJ,Falsey AR. Risk factors for Respiratory Syncytial Virus illness among patients with Chronic Obstructive Pulmonary Disease. COPD. 2013;10(3):293-9.

4. Falsey AR. Respiratory Syncytial Virus infection in elderly and high-risk adults. Exp Lung Res. 2005;31 Suppl 1:77.

5. Falsey AR,House S,et al. Risk Factors and Medical Resource Utilization of Respiratory Syncytial Virus,Human Metapneumovirus,and Influenza-Related Hospitalizations in Adults-A Global Study During the 2017-2019 Epidemic Seasons (Hospitalized Acute Respiratory Tract Infection [HARTI] Study). Open Forum Infect Dis. 2021;8(11):ofab491.

6. Branche AR,Falsey AR. Respiratory Syncytial Virus infection in older adults: an under-recognized problem. Drugs Aging. 2015;32(4):261-9.

7. Ang,Li Wei et al. "Characterisation of respiratory syncytial virus activity in children and adults presenting with acute respiratory illness at primary care clinics in Singapore,2014-2018." Influenza and other respiratory viruses vol. 14,4 (2020): 412-419. doi:10.1111/irv.12730

8. Nguyen-Van-Tam JS,O'Leary M,Martin ET,et al. Burden of respiratory syncytial virus infection in older and high-risk adults: a systematic review and meta-analysis of the evidence from developed countries. Eur Respir Rev. 2022;31(166):220105.

9. Stephens LM,Varga SM. Considerations for a Respiratory Syncytial Virus Vaccine Targeting an Elderly Population. Vaccines (Basel). 2021;9(6).

10. Walsh EE,Peterson DR,Falsey AR. Risk factors for severe respiratory syncytial virus infection in elderly persons. J Infect Dis. 2004;189(2):233-238.

11. Chan,A.,Malhotra,R.,Visaria,Sung,P.,Siok Seng,B. J.,Ching,& Tan,Y. W. (2020). Transitions in health,employment,social engagement and intergenerational Transfers in Singapore Study (THE SIGNS Study) – II: Cross-Sectional and Longitudinal analyses of Key aspects of Successful Ageing. Centre for Ageing Research and Education,Duke-NUS Medical School.https://www.duke-nus.edu.sg/docs/librariesprovider3/publications-docs/the-signs-study---ii-report-(revised).pdf?sfvrsn=b391ced0_0

12. Department of Statistics Singapore. https://www.singstat.gov.sg/find-data/search-by-theme/population/elderly-youth-and-gender-profile/latest-data. Retrieved from: Asian Development Bank. (2020). Singapore's Care System and Population Aging: Challenges and Options. https://www.adb.org/sites/default/files/publication/637416/singapore-care-system-population-aging.pdf

13. Centers for Disease Control and Prevention. (n.d.). How RSV spreads. Centers for Disease Control and Prevention. https://www.cdc.gov/rsv/causes/index.html