Costs of influenza-associated healthcare: an umbrella review and meta-regression analysis
- 1London School of Hygiene and Tropical Medicine
Abstract
BackgroundEstimates of the healthcare costs associated with influenza treatment are essential for cost-effectiveness analyses that inform preventative and treatment strategies such as vaccination and non-pharmaceutical interventions. Existing evidence varies across treatment settings, age groups, and countries and there is little data from low- and middle-income settings.
MethodsWe conducted an umbrella review of systematic reviews and meta-analyses reporting direct admitted and non-admitted hospitalisation costs of seasonal influenza treatment in children, adults, and older people. We supplemented an evidence gap with a systematised review of studies reporting adult non-admitted treatment costs. Costs were extracted and adjusted to 2023 USD. We fitted a Bayesian mixed-effects model to estimate influenza treatment costs using national economic indicators, age group, and treatment setting as a priori predictors. We predicted admitted and non-admitted treatment costs for children, adults, and older people in 195 countries and territories.
ResultsSeven reviews were included in the umbrella review, supplemented by 17 primary studies for adult non-admitted care. Extracted data points most frequently described admitted treatment costs and came from high-income countries. The best-fitting model used healthcare expenditure per capita to predict treatment costs, with country-level random effects. Estimated costs increased with healthcare expenditure per capita, were higher for admitted than non-admitted care, and were highest for adults and lowest for children.
ConclusionsThis study provides novel estimates of influenza-associated healthcare costs across age groups and treatment settings by synthesising the available global evidence. By extrapolating to settings without data, our estimates can inform future economic evaluation studies of influenza interventions worldwide.
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BibTeX
@misc{goodfellow2026costs,
title = {{Costs of influenza-associated healthcare: an umbrella review and meta-regression analysis}},
author = {L. Goodfellow and G. T. B. Young and E. van Leeuwen and P. Lambach and M. Jit and R. M. Eggo and S. R. Procter},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.08.26365049},
url = {https://www.medrxiv.org/content/10.64898/2026.10.08.26365049v1},
note = {CC BY-NC},
}
RIS
TY - UNPB
TI - Costs of influenza-associated healthcare: an umbrella review and meta-regression analysis
AU - L. Goodfellow
AU - G. T. B. Young
AU - E. van Leeuwen
AU - P. Lambach
AU - M. Jit
AU - R. M. Eggo
AU - S. R. Procter
PY - 2026
DA - 2026/10/08
PB - medRxiv
DO - 10.64898/2026.10.08.26365049
UR - https://www.medrxiv.org/content/10.64898/2026.10.08.26365049v1
AB - BackgroundEstimates of the healthcare costs associated with influenza treatment are essential for cost-effectiveness analyses that inform preventative and treatment strategies such as vaccination and non-pharmaceutical interventions. Existing evidence varies across treatment settings, age groups, and countries and there is little data from low- and middle-income settings. MethodsWe conducted an umbrella review of systematic reviews and meta-analyses reporting direct admitted and non-admitted hospitalisation costs of seasonal influenza treatment in children, adults, and older people. We supplemented an evidence gap with a systematised review of studies reporting adult non-admitted treatment costs. Costs were extracted and adjusted to 2023 USD. We fitted a Bayesian mixed-effects model to estimate influenza treatment costs using national economic indicators, age group, and treatment setting as a priori predictors. We predicted admitted and non-admitted treatment costs for children, adults, and older people in 195 countries and territories. ResultsSeven reviews were included in the umbrella review, supplemented by 17 primary studies for adult non-admitted care. Extracted data points most frequently described admitted treatment costs and came from high-income countries. The best-fitting model used healthcare expenditure per capita to predict treatment costs, with country-level random effects. Estimated costs increased with healthcare expenditure per capita, were higher for admitted than non-admitted care, and were highest for adults and lowest for children. ConclusionsThis study provides novel estimates of influenza-associated healthcare costs across age groups and treatment settings by synthesising the available global evidence. By extrapolating to settings without data, our estimates can inform future economic evaluation studies of influenza interventions worldwide.
ER -