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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...

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Autores principales: Whittington, Melanie D., Pearson, Steven D., Rind, David M., Campbell, Jonathan D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Society for Pharmacoeconomics and Outcomes Research, Inc. Published by Elsevier Inc. 2022
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.
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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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