Abstract
Objectives
COVID-19 is associated with significant morbidity and mortality. This study aims to synthesize evidence to assess the cost-effectiveness of remdesivir (RDV) for the treatment of hospitalized patients with COVID-19 in England and Wales.
Methods
A probabilistic cost-effectiveness analysis was conducted informed by 2 large trials and uses a partitioned survival approach to assess short- and long-term clinical consequences and costs associated with COVID-19 in a hypothetical cohort of hospitalized patients requiring supplemental oxygen at the start of treatment. Given that it is uncertain whether RDV reduces death, 2 analyses are presented, assuming RDV either reduces death or does not. Published sources were used for long-term clinical, quality of life, and cost parameters.
Results
Under the assumption that RDV reduces death, the incremental cost-effectiveness ratio for RDV is estimated at £11 881 per quality-adjusted life-year gained compared with standard of care (SoC) (probabilistic incremental cost-effectiveness ratio £12 400). The probability for RDV to be cost-effective is 74% at a willingness-to-pay threshold of £20 000 per quality-adjusted life-year gained. RDV was no longer cost-effective when the hazard ratio for overall survival compared with SoC was >0·915.
Conclusions
Results from this study suggest that using RDV for the treatment of hospitalized patients with COVID-19 is likely to represent a cost-effective use of National Health Service resources at current willingness-to-pay threshold in England and Wales, only if it prevents death. Results needs to be interpreted caution as vaccination was introduced and the SoC and evidence available have also evolved considerably since the analysis is conducted.
【저자키워드】 COVID-19, coronavirus, Remdesivir, cost-effectiveness, United Kingdom, Economic evaluation, Health technology assessment, 【초록키워드】 Treatment, vaccination, Probability, Cohort, survival, death, Quality of life, morbidity and mortality, threshold, England, resource, parameters, RDV, Evidence, Analysis, National Health Service, Standard of care, hazard ratio, assumption, large trial, SOC, approach, objective, Prevent, Result, conducted, were used, introduced, hospitalized patient, analysis, reduce, clinical consequence, hypothetical, requiring supplemental oxygen, with COVID-19, 【제목키워드】 England,