The economic burden of COVID-19 in a region with stringent response measures: A case study of Taiwan

Elise Chia-Hui Tan^a, Fei-Yuan Hsiao^b,c,d,**, Ming-Chin Yang^e,*

^a Department of Health Service Administration, College of Public Health, China Medical University, Taichung, Taiwan

^b Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan

^c School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan

^d Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan

^e Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan

The COVID-19 pandemic has imposed a significant economic burden globally, particularly in regions with stringent response measures. This study aimed to assess the economic impact of COVID-19 in Taiwan, focusing on both direct and indirect costs. A cost-of-illness analysis was conducted, utilizing data from the Taiwan Centers for Disease Control (CDC), national databases, epidemiological studies, and economic surveys. The analysis included both direct costs (e.g., hospital admissions, outpatient care) and indirect costs (e.g., productivity losses due to long COVID, absenteeism, caregiving duties). The study encompassed Taiwan's population of 23.2 million, with particular attention to age-specific impacts on economic outcomes. The total economic burden of COVID-19 in Taiwan was estimated at USD 4431 million. Direct costs accounted for 24.40% (USD 1081 million), while indirect costs constituted 75.60% (USD 3350 million. The working age population bore the majority of this burden, with 88.68% (USD 3090 million) of total costs attributed tothis group. Long COVID significantly contributed to the economic impact, causing a 35% reduction in productivity.Sensitivity analysis revealed that the frequency of outpatient visits among working age and elderly cohorts was acritical factor influencing overall costs. The study underscores the substantial economic burden of stringent COVID-19 policies in Taiwan, highlighting that indirect costs were nearly three times higher than direct costs. The findings emphasize the need for resilient healthcare systems and support for affected workers, particularly in regions with similar response strategies. The methodological approach offers insights that could be applied to other regions facing similar challenges.