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A Retrospective Claims Data Analysis on the Burden of COVID-19-Related Hospitalization in Adults at High Risk for
Timotheus Stremel1, Svitlana Schnaidt2, Nicole Bihrer3
1Xcenda GmbH, Part of Cencora Inc., Lange Laube 31, 30159, Hannover, Germany. timotheus.stremel@cencora.com.
Insights
High-risk COVID-19 patients face significant healthcare costs and mortality. Preventing severe disease progression in these individuals is crucial for reducing the economic burden on healthcare systems.
Area of Science:
- Health Economics
- Infectious Disease Epidemiology
- Pharmacoeconomics
Background:
- Individuals at high risk for severe coronavirus disease 2019 (COVID-19) progression are more likely to be hospitalized.
- Nirmatrelvir/ritonavir (NMV/r) is an antiviral medication designed to mitigate severe COVID-19 outcomes.
- Understanding the economic impact of hospitalizations for high-risk COVID-19 patients is essential for healthcare resource allocation.
Purpose of the Study:
- To assess the resource utilization and associated healthcare costs for adults hospitalized with COVID-19 who are at high risk for severe disease progression.
- To analyze the economic burden from a payer's perspective in Germany.
- To inform strategies for preventing severe COVID-19 and managing healthcare expenditures.
Main Methods:
- Retrospective analysis of German claims data.
- Identification of high-risk criteria based on diagnoses, operations, procedures, and prescriptions.
- Categorization of patients by eligibility for Nirmatrelvir/ritonavir (NMV/r) treatment.
- Analysis focused on the Delta variant period (June 21, 2021, to December 31, 2021).
Main Results:
- Approximately 60% of individuals in the database were identified as high-risk for severe COVID-19.
- Among high-risk patients hospitalized for COVID-19 (n=2938), two-thirds were eligible for NMV/r treatment.
- Average length of hospital stay was 11.3 days, with an inpatient mortality rate of 18.9%.
- Mean healthcare costs per hospitalization were €8728.
Conclusions:
- Hospitalizations for high-risk COVID-19 patients represent a significant economic burden in Germany.
- Advanced age and cardiovascular conditions were the most common risk factors identified.
- Preventing severe COVID-19 progression and subsequent hospitalizations is vital for alleviating healthcare system costs and optimizing resource allocation.
Introduction:
Individuals at increased risk of severe coronavirus disease 2019 (COVID-19) progression have a higher probability of being hospitalized. Nirmatrelvir/ritonavir (NMV/r) is an antiviral drug aiming to prevent severe disease courses. Our study aimed to assess the resource utilization and costs of adults hospitalized for COVID-19 at high risk for severe disease progression.
Methods:
A retrospective study was conducted using German claims data. The presence of high-risk criteria was determined through recorded diagnoses, operations, procedures, and prescriptions. Individuals at high risk for severe COVID-19 progression, primarily hospitalized for COVID-19, required a recorded diagnosis for COVID-19 and additionally a diagnosis of sepsis, pulmonary embolism, acute respiratory failure, pneumonia, or a remdesivir prescription. Patients were grouped by eligibility for NMV/r treatment (eligible, eligible with restrictions, and not eligible). The outcomes of interest were reported for the timeframe of the last dominant virus variant available in the database, i.e., Delta (June 21, 2021 to December 31, 2021).
Results:
Of approximately 3.7 million individuals continuously observable in the database, about 60% were identified as being at high risk for severe COVID-19 progression. Among high-risk individuals, 2938 patients were primarily hospitalized for COVID-19 between June 21, 2021, and December 31, 2021, two-thirds of which were suitable for NMV/r treatment (half without restrictions). Advanced age (86.3%) and cardiovascular conditions (83.9%) were the most prevalent of the predefined risk factors. Identified patients stayed, on average, 11.3 days in hospital, with inpatient mortality of 18.9%. These COVID-19-related hospitalizations resulted in mean healthcare costs of €8728.
Conclusions:
This study reflects the economic burden of hospitalized adult individuals with COVID-19 at high risk for severe disease progression from payer's perspective in Germany. Our findings highlight the need to prevent severe disease courses and associated hospitalizations to relieve healthcare systems regarding costs and resource allocation.
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