RT Journal Article SR Electronic T1 Examining unit costs for COVID-19 case management in Kenya JF BMJ Global Health JO BMJ Global Health FD BMJ Publishing Group Ltd SP e004159 DO 10.1136/bmjgh-2020-004159 VO 6 IS 4 A1 Edwine Barasa A1 Angela Kairu A1 Wangari Ng'ang'a A1 Marybeth Maritim A1 Vincent Were A1 Samuel Akech A1 Mercy Mwangangi YR 2021 UL http://gh.bmj.com/content/6/4/e004159.abstract AB 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.All data relevant to the study are included in the article or uploaded as supplemental information.