The Economic Burden of Coronavirus Disease 2019 (COVID-19): Evidence from Iran

Abstract

This study aimed to estimate both direct medical and indirect costs of treating the Coronavirus disease 2019 (COVID-19) from a societal perspective in the patients at a referral hospital in Fars province as well as the economic burden of COVID-19 in Iran in 2020.Methods:This is a partial economic evaluation and a cross-sectional cost-description study conducted descriptively-analytically and based on the data of the COVID-19 patients referred to a referral university hospital in Fars province between March and July 2020. The data were collected by examining the patients' records and accounting information systems. The subjects included all the inpatients with COVID-19 (477 individuals) who admitted to the medical centre during the four months. Bottom-up costing, incidence-based and income-based human capital approaches were used as the main methodological features of this study.Results: The mean direct medical costs were estimated 28,240,025,968 Rials ($ 1,791,172) in total and 59,203,409 Rials ($ 3,755) per person, a significant part of which (41 %) was that of intensive and general care beds (11,596,217,487 Rials equal to $ 735,510. (The second to which were the costs of medicines and medical consumables (28 %). The mean indirect costs including income loss due to premature death, economic production loss due to hospitalization and job absenteeism during recovery course were estimated 129,870,974 Rials ($ 11634) per person. Furthermore, the economic burden of the disease in the country for inpatient cases with the definitive diagnosis was 22,688,925,933,095 Rial equal to $ 1,439,083,784.Conclusion: The results of this study showed that the severe status of the disease would bring about the extremely high cost of illness in this case. It is estimated that the high prevalence rate of COVID-19 has been imposing a heavy economic burden on the country and health system directly that may result in rationing or painful cost-control approaches.

Direct and indirect cost of COVID-19 patients in Iran

“…The total indirect and direct costs were estimated at 5450.66 and 3362.49 PPP, respectively. Our results are consistent with a previous study in Iran, in which the total mean indirect and direct medical costs were estimated to be $ 11,634 and $3755, respectively ( 21 ). Kim et al performed a study to determine cost breakdowns associated with the 2009 pandemic H1N1 influenza in Korea (2013).…”

“…In our study, the main components of the total indirect costs were caused by missed workdays (88%), followed by premature death (12%). In contrast, in another study in Iran, income loss due to premature death was the main component of indirect costs ($10,190), followed by job absenteeism during the recovery course ($1065) and economic production loss due to hospitalization ($378) ( 21 ). Additionally, we found that direct non-medical costs accounted for a small proportion of total indirect costs (1.7%).…”

“…A study in China suggested that pre-existing diseases and advanced disease severity were strongly associated with higher costs ( 23 ). Similarly, in a study in Iran, ICU patients incurred higher costs than non-severe patients ($13,267 VS $2979) ( 21 ). Another study showed that length of hospital stay and in-hospital mortality increased with intensive care unit (ICU) and/or IMV usage, and costs increased with ICU and/or IMV usage ( 27 ).…”

“…The total cost of the disease was estimated at 2087 Million (PPP, Current International $). A cross-sectional cost-description study performed in Iran aimed to estimate direct medical and indirect costs of treating the Covid-19 found that the economic burden of the disease for inpatient cases was $1,439,083,784 ( 21 ). Jin et al conducted a cost-of-illness study to estimate the economic burden of Covid-19 in China (2021).…”

“…Similarly, in a study in China (2020), the highest mean cost was medicine, representing 45.1% of the total cost ( 23 ). Also, in a study in Iran, the main direct costs were related to medicines and medical consumables (28%) ( 21 ). Likewise, our results showed that after diagnostic costs (199.74 PPP), medicine costs (188.76 PPP) were the main component of outpatient costs.…”