Healthcare Costs of COVID-19 Versus Flu and Pneumonia - a Payer Perspective

Author(s)

Richards F1, Patterson B2, Ruppenkamp J3, Debnath R4, El Khoury AC5, DeMartino JK6, Bookhart B7, Holy C8, Coplan P9
1Janssen Global Services, Rahway, NJ, USA, 2Janssen Global Services, Basking Ridge , NJ, USA, 3Johnson & Johnson, New Brunswick, NJ, USA, 4Mu Sigma, Bangalore, NJ, India, 5Janssen Global Services, Raritan, NJ, USA, 6Janssen Scientific Affairs, Titusville, NJ, USA, 7Johnson & Johnson, Philadelphia, PA, USA, 8Johnson & Johnson, Somerville, MA, USA, 9Johnson & Johnson, Fort Washington, PA, USA

OBJECTIVES: Payer costs associated with the acute coronavirus 2019 disease (COVID-19) are not well documented. Our study evaluates payer costs of COVID-19 patients compared to those from patients with influenza and viral pneumonia.

METHODS: Patients with COVID-19 from October 1st, 2020, to February 1st, 2021, or with flu or pneumonia, from October 1st, 2018, to February 1st, 2019, and ≥ 6 months of continuous enrollment pre-and post-index, in IBM® MarketScan® Commercial Claims and Encounters and Medicare Supplemental databases, were identified. COVID-19 patients were further stratified based on severity of disease using the mild, moderate and severe disease signs and symptoms as defined by the Janssen ENSEMBLE Trial. Variables for all patients included demographics and comorbidities. Duration of disease for COVID-19 patients was defined as: 5 days before positive test to last related visit/prescription; for influenza: from first diagnosis to last related visit/prescription. A maximum 35-day gap was allowed between visits/prescriptions. Outcomes were all-cause and disease-specific costs for the entire duration of the disease. Influenza/pneumonia and COVID cohorts were matched (R package MatchIt –distance: “GLM” –method “nearest”), and 2021 inflation-adjusted costs were estimated using generalized linear model with gamma distribution and log link.

RESULTS: 6,176 Medicare [58.8% female, average age 75.1 (standard deviation (SD): 7.5) and 15,638 Commercially-insured patients [57% female, average age 33.5 (SD: 16.7)] were included, half COVID-19 and half influenza/pneumonia patients. All-cause and disease-specific costs for severe COVID-19 were statistically significantly greater than those for flu/pneumonia, for commercial and Medicare payers (Difference in costs: Commercial: all-cause: $34,564 (95% CI: $16,211-$52,916); disease-specific: $19,458 (95%CI: $9,989-$28,929); Medicare: all-cause: $33,727 (95%CI: $25,917-$41,538) disease-specific: $10,846 (95%CI: $8,114-$13,578)). Costs for moderate COVID-19 were significantly higher than influenza/pneumonia for commercial payers but not Medicare.

CONCLUSION: The cost of care for severe COVID-19 significantly exceeded those for influenza/pneumonia in patients matched on age and comorbidities.

Conference/Value in Health Info

2022-05, ISPOR 2022, Washington, DC, USA

Value in Health, Volume 25, Issue 6, S1 (June 2022)

Code

EE238

Topic

Economic Evaluation

Disease

Vaccines

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