Treatment with the antiviral combination nirmatrelvir–ritonavir (Paxlovid) was associated with fewer lost workdays and lower disability-related costs among US employees at high risk for severe COVID-19, according to a retrospective observational study in the Journal of Medical Economics.

Using insurance claims and workplace productivity data from large US employers, the researchers, led by scientists from Paxlovid maker Pfizer, compared productivity outcomes among high-risk employees diagnosed as having COVID who either received Paxlovid within five days of diagnosis or received no antiviral. 

Analyses of absences among treated and untreated workers and those on short-term disability (STD) and long-term disability (LTD) included 1,909, 20,065, and 20,318 employees, respectively. The study included data from December 2021 through December 2022, a period dominated by Omicron variants.

After 1:1 matching on age, sex, comorbidities, timing of infection, and baseline health care use, employees who received Paxlovid had 5% fewer workday absences, 17% fewer STD days, and 27% fewer LTD days per patient per month than untreated employees. 

Monthly absence-related costs per treated worker were $434 versus $468 in their untreated counterparts, and daily costs were $84 versus $108 in treated versus untreated STD workers and $4.39 versus $7.35 for treated and untreated LTD staff.

Health care costs 2 to 3 times higher for infected workers

COVID has remained a major driver of disability claims and lost productivity. The authors note that direct health care costs for those diagnosed as having COVID were two to three times higher than those of controls in the six months following infection.

They noted that the analysis was restricted to employees of large, self-insured firms and may not generalize to other workers or those with different insurance status. 

“Although findings indicate modest cost savings at the patient level, these savings could be substantial at the employer level, especially for employers with substantial populations of employees with specific comorbid conditions such as diabetes, overweight and obesity,” the researchers concluded.

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