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Health care costs of COVID-19 vs influenza and pneumonia
Fayolah Richards, Brandon J Patterson, Jill W Ruppenkamp
1Johnson & Johnson, 410 George St, New Brunswick, NJ 08901.
Insights
COVID-19 treatment costs significantly exceeded influenza or viral pneumonia (IP) costs, especially for severe cases. IP was less expensive than moderate COVID-19 for commercial payers, but more expensive than mild COVID-19 for all payers.
Area of Science:
- Health Economics
- Epidemiology
- Infectious Diseases
Background:
- The financial burden of COVID-19 treatment on healthcare systems is a critical concern.
- Understanding comparative treatment costs between COVID-19 and other respiratory illnesses like influenza or viral pneumonia (IP) is essential for resource allocation.
Purpose of the Study:
- To estimate and compare the treatment payments for COVID-19 versus influenza or viral pneumonia (IP) from a US payer perspective.
- To analyze cost differences based on disease severity and insurance type (Medicare vs. commercial).
Main Methods:
- Retrospective cohort analysis of IBM MarketScan databases (October 2020-February 2021 for COVID-19, October 2018-February 2019 for IP).
- Propensity score matching was used to create comparable cohorts.
- Inflation-adjusted all-cause payments (ACP) and disease-specific payments (DSP) were estimated using generalized linear models.
Main Results:
- COVID-19 treatment payments were significantly higher than IP payments across all severities.
- Severe/critical COVID-19 incurred substantially higher costs, with incremental DSP of $24,852 and ACP of $50,325 compared to IP.
- Influenza or viral pneumonia (IP) was less expensive than moderate COVID-19 for commercial payers but not Medicare; IP was more expensive than mild COVID-19 for all payers.
Conclusions:
- Severe COVID-19 treatment is significantly more costly than influenza or viral pneumonia (IP) treatment.
- Cost comparisons between IP and COVID-19 vary by disease severity and payer type, highlighting the complex economic impact of the pandemic.
Objectives:
To estimate payments for the treatment of COVID-19 compared with that of influenza or viral pneumonia (IP), from the perspective of the US payer.
Study Design:
Retrospective cohort analysis.
Methods:
Patients with COVID-19 during the period from October 1, 2020, to February 1, 2021, or IP during the period from October 1, 2018, to February 1, 2019, in the IBM MarketScan databases were identified. The index was defined as the date of the first COVID-19 or IP diagnosis. Patients with COVID-19 were stratified by severity. Variables for all patients included demographics and comorbidities at the time of index and duration of disease. IP and COVID-19 cohorts were matched using propensity scores, and inflation-adjusted all-cause payments (ACP), and disease-specific payments (DSP) for IP vs COVID-19 were estimated using generalized linear models.
Results:
Matched cohorts included 6332 Medicare (female, 58.5%; mean [SD] age, 75.3 [7.6] years), and 397,532 commercially insured patients (female, 57.6%; mean [SD] age, 34.7 [16.7] years). ACP and DSP were significantly higher in the COVID-19 cohort vs IP cohort. Payments for severe/critical COVID-19 were significantly greater than those for IP, with adjusted marginal incremental DSP and ACP of $24,852 (95% CI, $21,573-$28,132) and $50,325 (95% CI, $43,932-$56,718), respectively. IP was significantly less expensive than moderate COVID-19 for commercial payers but not Medicare. IP was more expensive than mild COVID-19 for all payers.
Conclusions:
Payments associated with severe/critical COVID-19 significantly exceeded those associated with IP. For Medicare, IP was more expensive than mild or moderate COVID-19. For commercial payers, IP was less expensive than moderate COVID-19 but more expensive than mild COVID-19.
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