Respiratory syncytial virus (RSV) is a major cause of severe respiratory disease in older adults aged ≥65 years, adults with underlying comorbidities such as chronic heart or lung disease, and those with immunocompromising conditions. A systematic literature review (SLR) of publications in the past 20 years was conducted on 18 May 2022 to better understand the global economic [(cost and healthcare resource use (HCRU)] and health-related quality of life (HRQOL) burden of RSV infection in adults aged ≥18 years, with and without comorbidities, and to highlight any critical evidence gaps. PubMed, Embase, Cochrane, PsycINFO, and EconLit databases were searched, with no language limits. Population size for extraction of HCRU outcomes was limited to ≥100 patients; there were no size limits for other outcomes. Sixty-five studies were included for RSV costs (n = 21), HCRU (n = 34), and HRQOL (n = 12). This SLR revealed major evidence gaps, including limited data beyond the inpatient hospital setting; inconsistent age subgroups for cost; few HCRU outcomes stratified by age; lack of cost, HCRU, and HRQOL data by comorbidity; variation in types of cost outcomes reported; lack of information on indirect costs; lack of geographic diversity, with most cost and HCRU studies conducted in the United States; and lack of country-specific HRQOL data. HRQOL data were limited for patients aged <60 years, with no studies that reported RSV-specific utilities or quality-of-life impairments in adults. The evidence limitations and gaps identified highlight the need to better characterize the economic and humanistic burden of RSV in adults. This information will be critical for policy decision-makers to assess the value and cost-effectiveness of vaccination strategies among those at risk of severe outcomes due to increased age and underlying comorbidities.
