According to a retrospective observational study published in the Journal of Medical Economics, treatment with nirmatrelvir–ritonavir (Paxlovid) among US employees at high risk for severe COVID-19 was associated with reduced lost workdays and lower disability-related costs. Using insurance claims and workplace productivity data, researchers compared high-risk employees who received Paxlovid within five days of COVID-19 diagnosis with those who did not receive antiviral therapy, demonstrating improved productivity outcomes with early Paxlovid use. The study was published in the Journal of Medical Economics by Maria M. and colleagues.
This study aimed to assess whether the treatment with nirmatrelvir-ritonavir, compared with no antiviral treatment of high-risk employees with diagnosed COVID-19, is associated with better outcomes of workplace productivity.
This retrospective matched cohort study was based on data from the Merative MarketScan Health and Productivity Management Database. Adult employees at high risk for severe COVID-19 were identified after a COVID-19 diagnosis occurring on or after December 16, 2021. Each treated employee was directly matched 1:1 with an untreated employee based on age, sex, calendar quarter, Charlson Comorbidity Index, and pre-period acute care utilization. Employees were followed for a 6-month pre-period and a post-period of at least 30 days.
Treated employees were defined as those who filed a pharmacy claim for nirmatrelvir-ritonavir within 5 days following the diagnosis of COVID-19, whereas matched untreated employees did not have NMV/r use recorded in the same period.
The primary outcomes were lost workdays per patient per month (PPPM) due to:
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Absence
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Short-term disability (STD)
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Long-term disability (LTD)
Associated indirect costs related to productivity loss were also estimated. Statistical analyses included paired tests and two-part hurdle models to account for zero-inflated data.
Key findings
Among matched cohorts, NMV/r treatment was consistently associated with fewer lost workdays across all productivity measures:
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Absence:
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Treated: 2.06 ± 2.37 days PPPM
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Untreated: 2.22 ± 2.49 days PPPM
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P < 0.05
Short-term disability:
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Treated: 0.41 ± 2.17 days PPPM
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Untreated: 0.52 ± 2.42 days PPPM
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P < 0.001
Long-term disability:
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Treated: 0.02 ± 0.061 days PPPM
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Untreated: 0.04 ± 0.79 days PPPM
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P < 0.05
Model-based analyses confirmed these findings:
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5% fewer absence days (mean ratio 0.95; 95% CI, 0.91–0.99)
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17% fewer STD days (mean ratio 0.83; 95% CI, 0.77–0.88)
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27% fewer LTD days (mean ratio 0.73; 95% CI, 0.69–0.78)All differences were statistically significant (P < 0.01).
Nirmatrelvir-ritonavir treatment was associated with significantly fewer lost workdays and reduced disability following COVID-19 infection, indicating lower indirect societal burden among high-risk employees. These results extend the benefit of antiviral therapy beyond traditional clinical outcomes to support a role in mitigating the long-term economic impact of COVID-19.
Reference:
Fernandez, M. M., Brady, B. L., Evans, K. A., Sidhu, G. S., Cislo, P., Ernst, F. R., … Mokgokong, R. (2025). Comparison of work productivity losses in the United States among employees with COVID-19 at high-risk of severe disease who were untreated or treated with nirmatrelvir/ritonavir. Journal of Medical Economics, 28(1), 2198–2215. https://doi.org/10.1080/13696998.2025.2601454