TY - JOUR
T1 - The cost of primary care consultations associated with long COVID in non-hospitalised adults
T2 - a retrospective cohort study using UK primary care data
AU - Tufts, Jake
AU - Guan, Naijie
AU - Zemedikun, Dawit T.
AU - Subramanian, Anuradhaa
AU - Gokhale, Krishna
AU - Myles, Puja
AU - Williams, Tim
AU - Marshall, Tom
AU - Calvert, Melanie
AU - Matthews, Karen
AU - Nirantharakumar, Krishnarajah
AU - Jackson, Louise J.
AU - Haroon, Shamil
N1 - Funding Information:
CPRD supplies anonymised UK health data for public health research sponsored by the National Institute for Health Research (NIHR) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). The UK's Health Research Authority Research Ethics Committee provides ethical approval to CPRD annually. Therefore, no additional ethical approval is required for observational studies using CPRD Aurum data for public health research, subject to individual research protocols meeting CPRD data governance requirements. Access to the CPRD database in this study obtained the protocol approval from the CPRD Independent Scientific Advisory Committee (Reference ID: 22_001855). All methods were performed in accordance with relevant guidelines and regulations. Informed consent was obtained from all subjects and/or their legal guardians.
Funding Information:
All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: JT has no relevant conflicts of interest to declare. DTZ has no relevant conflicts of interest to declare. AS has no relevant conflicts of interest to declare. NG has no relevant conflicts of interest to declare. KG has no relevant conflicts of interest to declare. KN has no relevant conflicts of interest to declare. LJ has no relevant conflicts of interest to declare. SH receives research funding from the NIHR and UKRI. PM has no relevant conflicts of interest to declare. TM has no relevant conflicts of interest to declare. TW has not relevant conflicts of interest. KM has no relevant conflicts of interest. MJC is director of the Birmingham Health Partners Centre for Regulatory Science and Innovation and director of the Centre for Patient Reported Outcomes Research and is an NIHR senior investigator. MJC receives funding from the NIHR, UKRI, NIHR Birmingham Biomedical Research Centre, NIHR Surgical Reconstruction and Microbiology Research Centre, NIHR ARC West Midlands, NIHR Oxford-Birmingham Blood and Transplant Research Unit in Precision and Cellular Therapeutics, UK SPINE, European Regional Development Fund-Demand Hub and Health Data Research UK at the University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, Innovate UK (part of UKRI), Macmillan Cancer Support, UCB Pharma, Janssen, GlaxoSmithKline, and Gilead. MJC has received personal fees from Astellas, Aparito, CIS Oncology, Takeda, Merck, Daiichi Sankyo, Glaukos, GlaxoSmithKline, and the Patient-Centered Outcomes Research Institute outside the submitted work. In addition, a family member owns shares in GlaxoSmithKline.
Funding Information:
This work is independent research jointly funded by the National Institute for Health and Care Research (NIHR) and UK Research and Innovation (UKRI) (Therapies for Long COVID in non-hospitalised individuals: From symptoms, patient reported outcomes and immunology to targeted therapies (The TLC Study), COV-LT-0013). The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR, the Department of Health and Social Care or UKRI.
Publisher Copyright:
© 2023, The Author(s).
PY - 2023/11/20
Y1 - 2023/11/20
N2 - Background: The economic impact of managing long COVID in primary care is unknown. We estimated the costs of primary care consultations associated with long COVID and explored the relationship between risk factors and costs. Methods: Data were obtained on non-hospitalised adults from the Clinical Practice Research Datalink Aurum primary care database. We used propensity score matching with an incremental cost method to estimate additional primary care consultation costs associated with long COVID (12 weeks after COVID-19) at an individual and UK national level. We applied multivariable regression models to estimate the association between risk factors and consultations costs beyond 12 weeks from acute COVID-19. Results: Based on an analysis of 472,173 patients with COVID-19 and 472,173 unexposed individuals, the annual incremental cost of primary care consultations associated with long COVID was £2.44 per patient and £23,382,452 at the national level. Among patients with COVID-19, a long COVID diagnosis and reporting of longer-term symptoms were associated with a 43% and 44% increase in primary care consultation costs respectively, compared to patients without long COVID symptoms. Older age, female sex, obesity, being from a white ethnic group, comorbidities and prior consultation frequency were all associated with increased primary care consultation costs. Conclusions: The costs of primary care consultations associated with long COVID in non-hospitalised adults are substantial. Costs are significantly higher among those diagnosed with long COVID, those with long COVID symptoms, older adults, females, and those with obesity and comorbidities.
AB - Background: The economic impact of managing long COVID in primary care is unknown. We estimated the costs of primary care consultations associated with long COVID and explored the relationship between risk factors and costs. Methods: Data were obtained on non-hospitalised adults from the Clinical Practice Research Datalink Aurum primary care database. We used propensity score matching with an incremental cost method to estimate additional primary care consultation costs associated with long COVID (12 weeks after COVID-19) at an individual and UK national level. We applied multivariable regression models to estimate the association between risk factors and consultations costs beyond 12 weeks from acute COVID-19. Results: Based on an analysis of 472,173 patients with COVID-19 and 472,173 unexposed individuals, the annual incremental cost of primary care consultations associated with long COVID was £2.44 per patient and £23,382,452 at the national level. Among patients with COVID-19, a long COVID diagnosis and reporting of longer-term symptoms were associated with a 43% and 44% increase in primary care consultation costs respectively, compared to patients without long COVID symptoms. Older age, female sex, obesity, being from a white ethnic group, comorbidities and prior consultation frequency were all associated with increased primary care consultation costs. Conclusions: The costs of primary care consultations associated with long COVID in non-hospitalised adults are substantial. Costs are significantly higher among those diagnosed with long COVID, those with long COVID symptoms, older adults, females, and those with obesity and comorbidities.
KW - Cost
KW - COVID-19
KW - Economic
KW - Long COVID
KW - Primary care
UR - http://www.scopus.com/inward/record.url?scp=85177462577&partnerID=8YFLogxK
U2 - 10.1186/s12875-023-02196-1
DO - 10.1186/s12875-023-02196-1
M3 - Article
C2 - 37986044
VL - 24
JO - BMC Primary Care
JF - BMC Primary Care
IS - 1
M1 - 245
ER -