The results are significant: between 2020 and 2024, Long COVID and ME/CFS cost Germany more than €250 billion. In 2024 alone, Long COVID and ME/CFS cost Germany €63.1 billion, equating to 1.5% of the nation’s GDP.
The rising cost of Long COVID and ME/CFS in Germany 2025
The German charity, the ME/CFS Research Foundation, and risk-modelling company Risklayer have published a report which modelled up-to-date data on the prevalence and societal costs of Long COVID and ME/CFS in Germany. The report, published on International ME Awareness Day (12 May) 2025, discloses that between 2020 and 2024, ME/CFS and Long COVID cost Germany more than €250 billion.
The report estimated that the annual cost in 2024 alone amounted to €63.1 billion which corresponds to around 1.5% of gross domestic product (GDP) of Europe’s largest economy. The cost burden of ME/CFS and Long COVID combined ranged from 0.7% of GDP in 2020, to 1.8% of GDP in 2022, to 1.5% of GDP in 2024.
Prevalence
The report utilised an innovative approach to prevalence, by combing existing data and findings from existing, published literature with novel data from a model specifically developed for the report. Using this, the report claims that by the end of 2024, 871,086 people in Germany were likely living with Long COVID, whilst an additional 650,183 people were living with ME/CFS (the latter includes ME/CFS diagnosed as a result of COVID-19/Long COVID). The figures were based on corrected modelling of the number of monthly SARS-CoV-2 infections in Germany since the start of the 2020 COVID-19 pandemic. The alternative model is available as a peer-review publication and indicates that in 2023-2024, the number of SARS-CoV-2 infections was likely 80-100 times higher than official data by the Robert Koch Institute (the federal public health institute in Germany) suggest.
The number of active Long COVID cases in Germany has, the report states, stabilised, with Long COVID cases peaking in 2022 at 1.75 million and then receding to around 870,000 at the end of 2024. Meanwhile, the number of ME/CFS cases has continued to rise, surpassing 650,000 at the end of 2024.
The authors acknowledge limitations in their model on 3 counts – lack of data (limited infection surveillance information including numbers of cases of COVID-19 overall, and Long COVID and ME/CFS incidence), biased data (including by whom data collected, for what purpose, consistency issues as to how medical practitioners apply diagnostic codes, and the profiles of patients presenting for diagnosis), and the complexity of the modelling method used.
In terms of Long COVID specifically, the model indicates that Long COVID cases were at their peak during 2022. Hence, annual costs attributable to Long COVID also peaked during 2022 at €47.2 billion. For ME/CFS, the modelled annual costs continued to rise (from €20.9 billion in 2020 to €30.9 billion in 2024) as more cases arise. Under the current scenario, modelling points to likely further increasing costs in the years ahead, as a result of new Long COVID and ME/CFS cases originating from a projected continued SARS-CoV-2 infection caseload.
The report models the costs of Long COVID as well as ME/CFS for two reasons. Firstly, Long COVID and ME/CFS share many key symptoms and thus many of the same costs. Secondly, a subset of people living with Long COVID over time also present with symptoms typical of ME/CFS, so the COVID-19 pandemic will likely lead to an increase in the prevalence of ME/CFS.
Results
| Annual Cost ME/CFS (€ billions) | Annual Cost Long COVID (€ billions) | TOTAL (€ billions) | |
| 2020 | 20.9 | 1.4 | 22.3 |
| 2021 | 21.8 | 10.4 | 32.2 |
| 2022 | 25.6 | 47.2 | 72.8 |
| 2023 | 29.6 | 34.4 | 64.0 |
| 2024 | 30.9 | 32.2 | 63.1 |
Together, it was found that Long COVID and ME/CFS consume a sizable share of Germany’s annual GDP – almost 1.5% – affecting economic productivity (due to reduced workforce participation and productivity losses), healthcare spending (increased demand for diagnostics, long-term care, rehabilitation and disability support), and other parts of the economy (where societal impacts are more far-reaching than workforce participation, such as unpaid care work, reduced expenditure on tourism and entertainment, community participation, insurance markets and more).
Importance
In the absence of any reliable data on the prevalence and the costs of Long COVID and ME/CFS it is difficult for stakeholders, such as governments and others, for example, the pharmaceutical and healthcare sectors, to quantify an adequate and justified response in terms of public spending and investment in research and healthcare. For governments, challenged by competing interests on allocation of limited funds, the case for the investment in research to limit and reduce the economic losses caused by ME/CFS and Long COVID needs to be made. The German figures make a strong case for a strategic and co-ordinated approach to improving outcomes relating to Long COVID and ME/CFS, through a range of measures.
The future – academic research suggests that that an optimal national investment in Germany into research and development of €676 million has the potential to generate €2.6 billion in savings, should a curative treatment for ME/CFS be successfully developed as a result. Thus far, as the ME/CFS Foundation states ” …. some €150 million have been made available for health care services research by the Federal Ministry of Health (BMG) , with another roughly €50 million provided for clinical and basic research by the Federal Ministry of Education and Research (BMBF). As such, the federal government spent approximately €40 million annually on Long COVID and ME/CFS research during the five-year period up until the end of 2024. Compared to the combined cost of both diseases in Germany in 2024 of €63.1 billion, average annual spending on research by the federal government equaled 0.06%.”
Overall, this study provides an up-to-date and robust data set to inform decisions around policy creation, research funding allocation, and health systems transformation in Germany, towards more effectively reducing the cost of Long COVID and ME/CFS and improving outcomes for people living with these diseases.
