Substantial direct medical costs for symptomatic COVID-19 cases in the US

Direct medical costs associated with symptomatic COVID-19 cases appear to be "substantially higher than other common infectious diseases", according to an article by US-based researchers.

The authors developed a Monte Carlo simulation model that represented the US population and investigated what would happen to each person infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), with potential resource use and direct medical costs estimated for a range of infection rates. The population infection rate was determined at the start of each simulation run, with the age distribution matching the reported age distribution of COVID-19 cases, and each infected person then moving through a probability tree of differing possible sequential clinical outcomes. Model input parameters were obtained from scientific literature or nationally representative data sources. Costs were reported in 2020 US dollar values, with a 3% discount rate applied.

The median direct medical cost for a single symptomatic SARS-CoV2 infection was $US3045 when including only costs accrued during the course of the infection, which increased to $3994 with inclusion of costs incurred after the infection, such as outpatient visits and hospitalisation. Median per-case costs ranged from $57−$96 for a person with mild illness that did not require hospitalisation, to $14 366 during the course of the infection for a single hospitalised case.

Analysis of different infection rates demonstrated that an 80% infection rate would result in 215 million symptomatic cases and 44.6 million hospitalisations in the US, corresponding to a median direct medical cost incurred during the course of the infection of $654 billion, which increased to $859.6 billion with inclusion of the costs during the 1-year post-discharge period. In contrast, 50% and 20% infection rates were estimated to cause 134.4 million and 53.8 million symptomatic cases, respectively, resulting in median direct medical costs during the course of the infection of $408.8 billion and $163.4 billion, respectively, which increased to $536.7 billion and $214.5 billion, respectively, with inclusion of 1-year post-discharge costs.

"[T]he direct medical costs of a symptomatic COVID-19 case tends to be substantially higher than other common infectious diseases", concluded the authors. "The significant difference in costs by attack rate across the U.S. population show the value of strategies that keep the attack as low as possible and, conversely, the potential cost of any "herd immunity" strategies that allow people to get infected".