Economic Burden of Norovirus in the United States: $10.6 Billion Annually

The estimated economic burden of norovirus, a common cause of acute gastroenteritis, is $10.6 billion per year in direct medical costs and costs of lost productivity, according to an AHRQ-funded study published in the Journal of Infectious Disease. This figure is based on a current incidence rate estimate in the United States of about 69 new cases per 1,000 people per year. A computational model developed by researchers found that employers and businesses are heavily impacted by the economic burden, most notably due to productivity losses driven by employee absenteeism. According to the model, norovirus outbreaks occurring in defined settings (e.g., schools or cruise ships) account for less than 10 percent of total annual costs, while sporadic cases occurring in the community account for more than 90 percent of total annual costs. These findings indicate the need for additional resources to improve disease tracking, control and prevention efforts, researchers concluded. The study offers insights into where and when infection prevention and control activities may yield the greatest returns. Access the abstract.

The Clinical and Economic Burden of Norovirus Gastroenteritis in the United States

Sarah M Bartsch 1, Kelly J O'Shea 1, Bruce Y Lee 1

Affiliations

PMID: 32671397
DOI: 10.1093/infdis/jiaa292

Abstract

Background: Although norovirus outbreaks periodically make headlines, it is unclear how much attention norovirus may receive otherwise. A better understanding of the burden could help determine how to prioritize norovirus prevention and control.

Methods: We developed a computational simulation model to quantify the clinical and economic burden of norovirus in the United States.

Results: A symptomatic case generated $48 in direct medical costs, $416 in productivity losses ($464 total). The median yearly cost of outbreaks was $7.6 million (range across years, $7.5-$8.2 million) in direct medical costs, and $165.3 million ($161.1-$176.4 million) in productivity losses ($173.5 million total). Sporadic illnesses in the community (incidence, 10-150/1000 population) resulted in 14 118-211 705 hospitalizations, 8.2-122.9 million missed school/work days, $0.2-$2.3 billion in direct medical costs, and $1.4-$20.7 billion in productivity losses ($1.5-$23.1 billion total). The total cost was $10.6 billion based on the current incidence estimate (68.9/1000).

Conclusion: Our study quantified norovirus' burden. Of the total burden, sporadic cases constituted >90% (thus, annual burden may vary depending on incidence) and productivity losses represented 89%. More than half the economic burden is in adults ≥45, more than half occurs in winter months, and >90% of outbreak costs are due to person-to-person transmission, offering insights into where and when prevention/control efforts may yield returns.

Keywords: burden; community; cost; norovirus; outbreaks.