Assessment of Medically-Attended COVID-19 Patient Risk Profiles and Health Care Resource Utilization (HCRU) and Costs in the U.S.


Chacon-Araya M1, Tkacz J2, Zagari M1, Bello T2, Lewing B2, Brusky S1
1Pardes Biosciences, Carlsbad, CA, USA, 2Inovalon, Bowie, MD, USA

OBJECTIVES: To assess healthcare costs for medically attended COVID-19 (MAC) patients vs. matched controls not presenting with COVID-19, to serve as a baseline for the value of potential therapeutics.

METHODS: This study was a retrospective analysis of administrative claims from multiple payer channels spanning 4/1/2020 to 6/30/2022 (Wuhan strain through omicron clinical variants). Inclusion criteria: 1) ICD-10-CM diagnosis code of COVID-19 (U07.1; index date), 2) 18+ years of age on index, and 3) at least -365/+30 days of continuous enrollment surrounding index. Baseline comorbid conditions were assessed, along with the proportion of patients presenting as high-risk for developing severe COVID-19 per CDC guidelines. HCRU and costs were assessed during the 180-day period following index, and were compared between a subset of MAC and non-MAC controls matched directly on age, gender, and baseline Deyo-Charlson Comorbidity Index (DCI). Descriptive statistics were presented for all outcomes, and bivariate tests of significance were used to assess differences between cohorts.

RESULTS: A total of 5,746,432 COVID-19 patients met all study inclusion criteria. Patients with MAC had a mean DCI score of 1.79±2.69, with 26.0% of patients presenting a DCI score ≥ 3, and with 49.7% qualifying as at high-risk for complications per the CDC guidelines. MAC patients also presented significantly greater ER visits (0.62±1.42 vs. 0.24±0.85), hospitalizations (0.28±0.66 vs. 0.09±0.38), and total medical costs ($13,011±$28,382 vs. $5,083±$15,061; ps < 0.001) compared to non-MAC controls.

CONCLUSIONS: A key feature of COVID-19 is higher costs and HCRU related to complications for patients with comorbidities. This study demonstrated that patients with comorbidities are more likely to experience complications and incur greater costs associated with ER visits, hospitalization, and other medical services. These data serve as a baseline for assessing the value of therapeutics that lower the risk of mild COVID-19 progressing to more severe disease.

Conference/Value in Health Info

2023-05, ISPOR 2023, Boston, MA, USA

Value in Health, Volume 26, Issue 6, S2 (June 2023)




Economic Evaluation


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