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The Cost-Effectiveness of Remdesivir for Hospitalized Patients With COVID-19
OBJECTIVES: This study aimed to estimate the cost-effectiveness of remdesivir, the first novel therapeutic to receive Emergency Use Authorization for the treatment of hospitalized patients with COVID-19, and identify key drivers of value to guide future pricing and reimbursement efforts. METHODS: A...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
International Society for Pharmacoeconomics and Outcomes Research, Inc. Published by Elsevier Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8856900/ https://www.ncbi.nlm.nih.gov/pubmed/35190252 http://dx.doi.org/10.1016/j.jval.2021.11.1378 |
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author | Whittington, Melanie D. Pearson, Steven D. Rind, David M. Campbell, Jonathan D. |
author_facet | Whittington, Melanie D. Pearson, Steven D. Rind, David M. Campbell, Jonathan D. |
author_sort | Whittington, Melanie D. |
collection | PubMed |
description | OBJECTIVES: This study aimed to estimate the cost-effectiveness of remdesivir, the first novel therapeutic to receive Emergency Use Authorization for the treatment of hospitalized patients with COVID-19, and identify key drivers of value to guide future pricing and reimbursement efforts. METHODS: A Markov model evaluated the cost-effectiveness of remdesivir in patients hospitalized with COVID-19 from a US healthcare sector perspective. A lifetime time horizon captured potential long-term costs and outcomes. Model outcomes included discounted total costs, life-years, and quality-adjusted life-years (QALYs). Remdesivir was modeled as an addition to standard of care and compared with standard of care alone, including dexamethasone for patients requiring respiratory support. COVID-19 hospitalizations were assumed to be reimbursed through a single payment based on the respiratory support received alongside a remdesivir carveout payment in the base case. Sensitivity and scenario analyses identified key drivers. RESULTS: At a unit price of $520 per vial and assuming no survival benefit with remdesivir, the incremental cost-effectiveness was $298 200/QALY for patients with moderate to severe COVID-19 and $1 847 000/QALY for patients with mild COVID-19. Although current data do not support a survival benefit, if one was assumed, the cost-effectiveness estimate was $50 100/QALY for the moderate to severe population and $103 400/QALY for the mild population. Another key driver included the hospitalization payment structure (per diem vs bundled payment). CONCLUSIONS: With the current evidence available, remdesivir’s price is too high to align with its expected health gains for hospitalized patients with COVID-19. Results from this study provide a rationale for iterative health technology assessment. |
format | Online Article Text |
id | pubmed-8856900 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | International Society for Pharmacoeconomics and Outcomes Research, Inc. Published by Elsevier Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-88569002022-02-22 The Cost-Effectiveness of Remdesivir for Hospitalized Patients With COVID-19 Whittington, Melanie D. Pearson, Steven D. Rind, David M. Campbell, Jonathan D. Value Health Themed Section: COVID-19 OBJECTIVES: This study aimed to estimate the cost-effectiveness of remdesivir, the first novel therapeutic to receive Emergency Use Authorization for the treatment of hospitalized patients with COVID-19, and identify key drivers of value to guide future pricing and reimbursement efforts. METHODS: A Markov model evaluated the cost-effectiveness of remdesivir in patients hospitalized with COVID-19 from a US healthcare sector perspective. A lifetime time horizon captured potential long-term costs and outcomes. Model outcomes included discounted total costs, life-years, and quality-adjusted life-years (QALYs). Remdesivir was modeled as an addition to standard of care and compared with standard of care alone, including dexamethasone for patients requiring respiratory support. COVID-19 hospitalizations were assumed to be reimbursed through a single payment based on the respiratory support received alongside a remdesivir carveout payment in the base case. Sensitivity and scenario analyses identified key drivers. RESULTS: At a unit price of $520 per vial and assuming no survival benefit with remdesivir, the incremental cost-effectiveness was $298 200/QALY for patients with moderate to severe COVID-19 and $1 847 000/QALY for patients with mild COVID-19. Although current data do not support a survival benefit, if one was assumed, the cost-effectiveness estimate was $50 100/QALY for the moderate to severe population and $103 400/QALY for the mild population. Another key driver included the hospitalization payment structure (per diem vs bundled payment). CONCLUSIONS: With the current evidence available, remdesivir’s price is too high to align with its expected health gains for hospitalized patients with COVID-19. Results from this study provide a rationale for iterative health technology assessment. International Society for Pharmacoeconomics and Outcomes Research, Inc. Published by Elsevier Inc. 2022-05 2022-02-19 /pmc/articles/PMC8856900/ /pubmed/35190252 http://dx.doi.org/10.1016/j.jval.2021.11.1378 Text en © 2022 International Society for Pharmacoeconomics and Outcomes Research, Inc. Published by Elsevier Inc. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Themed Section: COVID-19 Whittington, Melanie D. Pearson, Steven D. Rind, David M. Campbell, Jonathan D. The Cost-Effectiveness of Remdesivir for Hospitalized Patients With COVID-19 |
title | The Cost-Effectiveness of Remdesivir for Hospitalized Patients With COVID-19 |
title_full | The Cost-Effectiveness of Remdesivir for Hospitalized Patients With COVID-19 |
title_fullStr | The Cost-Effectiveness of Remdesivir for Hospitalized Patients With COVID-19 |
title_full_unstemmed | The Cost-Effectiveness of Remdesivir for Hospitalized Patients With COVID-19 |
title_short | The Cost-Effectiveness of Remdesivir for Hospitalized Patients With COVID-19 |
title_sort | cost-effectiveness of remdesivir for hospitalized patients with covid-19 |
topic | Themed Section: COVID-19 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8856900/ https://www.ncbi.nlm.nih.gov/pubmed/35190252 http://dx.doi.org/10.1016/j.jval.2021.11.1378 |
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