Out-of-pocket costs and productivity losses associated with influenza illness and caregiving in a household study in the United States, 2024-2025
- 1Centers for Disease Control and Prevention
Abstract
BackgroundNon-medically attended (NMA) and outpatient medically attended (MA) influenza illnesses contribute substantially to influenza disease burden in the United States. We leveraged a household study to estimate out-of-pocket and lost productivity costs of NMA and MA influenza illness.
MethodsThe Respiratory Virus Transmission Network for Influenza was a 2024-2025 case-ascertained household study at 3 U.S. sites. Influenza-positive index patients and household contacts self-reported daily symptoms, over-the-counter (OTC) medication use, medical care-seeking, time missed from work or activities, and self-collected nasal swabs for PCR testing. We included participants with PCR-confirmed influenza infection and influenza-like-illness symptoms who ever (MA) or never (NMA) sought medical care during follow-up. We obtained costs of OTC medications from retail websites and productivity costs from published values. We calculated OTC medication and lost productivity costs in 2025 USD for MA and NMA influenza separately and household-level lost productivity costs among caregivers for MA and NMA household members.
ResultsMedian out-of-pocket OTC medication costs were $6.38 (interquartile range [IQR] 2.92−11.60) among 594 MA and $3.72 (IQR 1.50−7.05) among 153 NMA influenza illnesses. Among participants [≥]15 years of age, median lost productivity was $315 (149−743) for MA and $248 (0−624) for NMA illnesses. Median household-level lost productivity for caregiving was $148 (households with 1 ill child), $379 (multiple ill children), and $0 ([≥]1 ill adult).
ConclusionsInfluenza causes substantial lost productivity costs within households. These estimates can inform future economic burden and cost effectiveness analyses.
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BibTeX
@misc{white2026outofpocket,
title = {{Out-of-pocket costs and productivity losses associated with influenza illness and caregiving in a household study in the United States, 2024-2025}},
author = {E. B. White and J. Pike and C. Y. Vargas and Y. Zhu and C. A. O'Neil and J. E. Biddle and L. Bristol and E. McNair and S. H. McLaren and E. Sano and T. A. Scott and R. Presti and S. A. Fritz and L. A. Prosser and M. S. Stockwell and C. G. Grijalva and J. H. Kwon and A. Mellis},
howpublished = {medRxiv},
year = {2026},
month = sep,
doi = {10.64898/2026.09.10.26362662},
url = {https://www.medrxiv.org/content/10.64898/2026.09.10.26362662v1},
note = {CC0},
}
RIS
TY - UNPB
TI - Out-of-pocket costs and productivity losses associated with influenza illness and caregiving in a household study in the United States, 2024-2025
AU - E. B. White
AU - J. Pike
AU - C. Y. Vargas
AU - Y. Zhu
AU - C. A. O'Neil
AU - J. E. Biddle
AU - L. Bristol
AU - E. McNair
AU - S. H. McLaren
AU - E. Sano
AU - T. A. Scott
AU - R. Presti
AU - S. A. Fritz
AU - L. A. Prosser
AU - M. S. Stockwell
AU - C. G. Grijalva
AU - J. H. Kwon
AU - A. Mellis
PY - 2026
DA - 2026/09/10
PB - medRxiv
DO - 10.64898/2026.09.10.26362662
UR - https://www.medrxiv.org/content/10.64898/2026.09.10.26362662v1
AB - BackgroundNon-medically attended (NMA) and outpatient medically attended (MA) influenza illnesses contribute substantially to influenza disease burden in the United States. We leveraged a household study to estimate out-of-pocket and lost productivity costs of NMA and MA influenza illness. MethodsThe Respiratory Virus Transmission Network for Influenza was a 2024-2025 case-ascertained household study at 3 U.S. sites. Influenza-positive index patients and household contacts self-reported daily symptoms, over-the-counter (OTC) medication use, medical care-seeking, time missed from work or activities, and self-collected nasal swabs for PCR testing. We included participants with PCR-confirmed influenza infection and influenza-like-illness symptoms who ever (MA) or never (NMA) sought medical care during follow-up. We obtained costs of OTC medications from retail websites and productivity costs from published values. We calculated OTC medication and lost productivity costs in 2025 USD for MA and NMA influenza separately and household-level lost productivity costs among caregivers for MA and NMA household members. ResultsMedian out-of-pocket OTC medication costs were $6.38 (interquartile range [IQR] 2.92−11.60) among 594 MA and $3.72 (IQR 1.50−7.05) among 153 NMA influenza illnesses. Among participants [≥]15 years of age, median lost productivity was $315 (149−743) for MA and $248 (0−624) for NMA illnesses. Median household-level lost productivity for caregiving was $148 (households with 1 ill child), $379 (multiple ill children), and $0 ([≥]1 ill adult). ConclusionsInfluenza causes substantial lost productivity costs within households. These estimates can inform future economic burden and cost effectiveness analyses.
ER -