INTRODUCTION: We estimated unit costs for COVID-19 case management for patients with asymptomatic, mild-to-moderate, severe and critical COVID-19 disease in Kenya .
METHODS: We estimated per-day unit costs of COVID-19 case management for patients . We used a bottom-up approach to estimate full economic costs and adopted a health system perspective and patient episode of care as our time horizon . We obtained data on inputs and their quantities from data provided by three public COVID-19 treatment hospitals in Kenya and augmented this with guidelines . We obtained input prices from a recent costing survey of 20 hospitals in Kenya and from market prices for Kenya .
RESULTS: Per-day, per-patient unit costs for asymptomatic patients and patients with mild-to-moderate COVID-19 disease under home-based care are 1993.01 Kenyan shilling (KES) (US $18.89) and 1995.17 KES (US $18.991), respectively . When these patients are managed in an isolation centre or hospital, the same unit costs for asymptomatic patients and patients with mild-to-moderate disease are 6717.74 KES (US $63.68) and 6719.90 KES (US $63.70), respectively . Per-day unit costs for patients with severe COVID-19 disease managed in general hospital wards and those with critical COVID-19 disease admitted in intensive care units are 13 137.07 KES (US $124.53) and 63 243.11 KES (US $599.51).
CONCLUSION: COVID-19 case management costs are substantial, ranging between two and four times the average claims value reported by Kenya's public health insurer . Kenya will need to mobilise substantial resources and explore service delivery adaptations that will reduce unit costs.