In this paper we quantify the total economic impact of an epidemic over a complex network using tools from random matrix theory. Incorporating the direct and indirect costs of infection, we calculate the disease cost in the large graph limit for an SIS (Susceptible - Infected - Susceptible) infection process. We also give an upper bound on this cost for arbitrary finite graphs and illustrate both calculated costs using extensive simulations on random and real-world networks. We extend these calculations by considering the total social cost of an epidemic, accounting for both the immunization and disease costs for various immunization strategies and determining the optimal immunization. Our work focuses on the transient behavior of the epidemic, in contrast to previous research, which typically focuses on determining the steady-state system equilibrium.