B40-09 The Economic Burden of Long Covid in British Columbia, Canada

Rationale

Long COVID is emerging as a growing public health concern, with evidence indicating that 38-50% of people who recover from COVID-19 continue to experience ongoing symptoms. We quantified the economic burden of Long COVID by analyzing total healthcare utilization costs and contributions from inpatient hospitalizations, outpatient services and prescription drugs.

Methods

Using the British Columbia COVID-19 Cohort, adults identified with Long COVID using a validated model were followed from the time of Long COVID identification through December 31, 2024. A comparison cohort of COVID-19 survivors without Long COVID was constructed, with long COVID cases matched to non-long COVID individuals at a 1:2 ratio using propensity scores based on age, sex, geographic region, Charlson Comorbidity Index, and quintiles of the Material and Social Deprivation Index (measured at the finest geographical level). We used generalized linear models with generalized estimating equations to estimate excess medical costs. Direct medical costs in 2024 Canadian-dollars ($) were assessed using billing records for hospitalizations, outpatient services, and medication dispensations. Excess medical costs of Long COVID were estimated by comparing overall costs between the Long COVID and comparison cohorts, with the difference indicating the estimated excess medical costs associated with Long COVID.

Results

The final sample consisted of 42,804 Long COVID survivors and 86,646 COVID-19 survivors, with a mean (SD) baseline age of 52.8 (17.7) years for Long COVID survivors, of whom 59.9% were female. Direct medical costs for Long COVID were $10269 per patient-year, compared to $4177 per patient-year for COVID-19 survivors, resulting in excess costs of $6092 (95% CI 5910-6274) per patient-year. Overall excess costs and hospitalization-related costs peaked in 2021 [Overall: $8648 (95% CI 8249-9048); Hospitalization: $7167 (95% CI 6795-7538)], remained elevated in 2022 [Overall: $7693 (95% 7340-8046)], and declined steadily through 2024 [Overall: $3866 ($3635-4098)]. In contrast, medication-related excess costs increased progressively over time, reaching their highest level in 2024 [$901 (95% CI 824-978]. Outpatient care costs rose sharply in 2022 [$1103 (95% CI 1070-1137)], followed by a pronounced decline thereafter (Figure 1).

Conclusion

Direct medical excess costs for Long COVID were initially driven by acute hospitalizations in 2021-2022, but over time shifted toward a sustained increase in medication and outpatient care costs. These findings suggest that the economic impact is not limited to short-term increases in hospitalizations but increasingly reflects ongoing treatment requirements and persistent healthcare-utilization in the post-acute phase.

This abstract is funded by: None