Artikel ; Online: Cost-Effectiveness of Oral Nirmatrelvir/Ritonavir in Patients at High Risk for Progression to Severe COVID-19 in the United States.
2023 Band 27, Heft 2, Seite(n) 164–172
Abstract: Objectives: Nirmatrelvir/ritonavir (NMV/r) is an orally administered antiviral indicated for the outpatient treatment of patients with mild-to-moderate COVID-19 at high risk for disease progression to severe illness. We estimated the cost-effectiveness ... ...
| Abstract | Objectives: Nirmatrelvir/ritonavir (NMV/r) is an orally administered antiviral indicated for the outpatient treatment of patients with mild-to-moderate COVID-19 at high risk for disease progression to severe illness. We estimated the cost-effectiveness of NMV/r versus best supportive care for patients with mild-to-moderate COVID-19 at high risk for progression to severe illness from a US health sector perspective. Methods: A cost-effectiveness model was developed using a short-term decision-tree (1 year) followed by a lifetime 2-state Markov model (alive and dead). The short-term decision-tree captured costs and outcomes associated with the primary infection and healthcare utilization; survivors of the short-term decision-tree were followed until death assuming US quality-adjusted life years (QALYs), adjusted in the short-term for survivors of mechanical ventilation. Baseline rate of hospitalization and NMV/r effectiveness were taken from an Omicron-era US real-world study. Remaining inputs were informed by previous COVID-19 studies and publicly available US sources. Sensitivity analyses were conducted for all model inputs to test the robustness of model results. Results: NMV/r was found to decrease COVID-19 related hospitalizations (-0.027 per infected case) increase QALYs (+0.030), decrease hospitalization costs (-$1110), and increase total treatment cost (+$271), resulting in an incremental cost-effectiveness ratio of $8931/QALY. Results were most sensitive to baseline risk of hospitalization and NMV/r treatment effectiveness parameters. The probabilistic analysis indicated that NMV/r has a >99% probability of being cost-effective at a $100 000 willingness-to-pay threshold. Conclusions: NMV/r is cost-effective vs best supportive care for patients at high risk for severe COVID-19 from a US health sector perspective. |
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| Mesh-Begriff(e) | Humans ; United States/epidemiology ; Ritonavir/therapeutic use ; Cost-Benefit Analysis ; COVID-19/epidemiology ; COVID-19 Drug Treatment ; Lactams ; Leucine ; Nitriles ; Proline | |||||
| Chemische Substanzen | Ritonavir (O3J8G9O825) ; nirmatrelvir (7R9A5P7H32) ; Lactams ; Leucine (GMW67QNF9C) ; Nitriles ; Proline (9DLQ4CIU6V) | |||||
| Sprache | Englisch | |||||
| Erscheinungsdatum | 2023-12-02 | |||||
| Erscheinungsland | United States | |||||
| Dokumenttyp | Journal Article | |||||
| ZDB-ID | 1471745-1 | |||||
| ISSN | 1524-4733 ; 1098-3015 | |||||
| ISSN (online) | 1524-4733 | |||||
| ISSN | 1098-3015 | |||||
| DOI | 10.1016/j.jval.2023.11.003 | |||||
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| Datenquelle | MEDical Literature Analysis and Retrieval System OnLINE |
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