-
Model-based cost-effectiveness analysis of oral antivirals against SARS-CoV-2 in Korea
-
Youngji Jo, Sun Bean Kim, Munkhzul Radnaabaatar, Kyungmin Huh, Jin-Hong Yoo, Kyong Ran Peck, Hojun Park, Jaehun Jung
-
Epidemiol Health. 2022;44:e2022034. Published online March 12, 2022
-
DOI: https://doi.org/10.4178/epih.e2022034
-
-
17,127
View
-
675
Download
-
16
Web of Science
-
17
Crossref
-
Abstract
Summary
PDFSupplementary Material
-
Abstract
OBJECTIVES Many countries have authorized the emergency use of oral antiviral agents for patients with mild-to-moderate cases of coronavirus disease 2019 (COVID-19). We assessed the cost-effectiveness of these agents for reducing the number of severe COVID-19 cases and the burden on Korea’s medical system.
METHODS Using an existing model, we estimated the number of people who would require hospital/intensive care unit (ICU) admission in Korea in 2022. The treatment scenarios included (1) all adult patients, (2) elderly patients only, and (3) adult patients with underlying diseases only, compared to standard care. Based on the current health system capacity, we calculated the incremental costs per severe case averted and hospital admission for each scenario.
RESULTS We estimated that 236,510 COVID-19 patients would require hospital/ICU admission in 2022 with standard care only. Nirmatrelvir/ritonavir (87% efficacy) was predicted to reduce this number by 80%, 24%, and 17% when targeting all adults, adults with underlying diseases, and elderly patients (25, 8, and 4%, respectively, for molnupiravir, with 30% efficacy). Nirmatrelvir/ritonavir use is likely to be cost-effective, with predicted costs of US$8,878, US$8,964, and US$1,454, per severe patient averted for the target groups listed above, respectively, while molnupiravir is likely to be less cost-effective, with costs of US$28,492, US$29,575, and US$7,915, respectively.
CONCLUSIONS In Korea, oral treatment using nirmatrelvir/ritonavir for symptomatic COVID-19 patients targeting elderly patients would be highly cost-effective and would substantially reduce the demand for hospital admission to below the capacity of the health system if targeted to all adult patients instead of standard care.
-
Summary
Korean summary
본 연구는 감염병 수리모형을 바탕으로 두가지 항바이러스제의 (nirmatrelvir/ritonavir와 molnupiravir) 비용 효익을 평가하였다. 본 모델에 따르면, 2022년 한국에서, 현재 의료시스템의 수용한계를 넘는 코로나 19 대유행이 발생할 때, nirmatrelvir/ritonavir 를 코로나 감염 및 증상 있는 고령층 환자들을 대상으로 투여할 경우 높은 비용 효익이 기대되고 (중증환자 1명 감소효과에$1,454 비용소요), 성인 환자 대상으로 투여할 경우, (molnupiravir이나 nirmatrelvir/ritonavir를 투여하지 않는) 일반 치료에 비해서 전체 입원 수요를 80% 줄일 것으로 기대된다.
Key Message
Given an expected high epidemic resurgence in 2022 that could exceed South Korea’s current health system capacity, oral treatment using nirmatrelvir/ritonavir for symptomatic COVID-19 patients may be a highly cost-effective solution if targeted to elderly patients ($1,454 per severe case averted) and substantially reduce the demand for hospital admission (80%, 188,478 patients) below the capacity of the health system if targeted to all adult patients compared to standard care.
-
Citations
Citations to this article as recorded by
- Cost-Utility Model of Nirmatrelvir/Ritonavir in Brazil: Analysis of a Vaccinated Population
Ricardo R.A. Fernandes, Bruno M. Barros, Milene R. da Costa, Carlos A.S. Magliano, Bernardo R. Tura, Quenia Cristina D. Morais, Marisa Santos Value in Health Regional Issues.2024; 40: 74. CrossRef - Cost-effectiveness of nirmatrelvir/ritonavir for high-risk adult outpatients with COVID-19 in Japan
Takahito Mizuno, Yu Kondo, Mikiyasu Sakai, Kenichi Saneyasu, Ryota Kojima, Yoshio Miyake Journal of Infection and Chemotherapy.2024; 30(8): 716. CrossRef - Lessons Learned from Model-based Economic Evaluations of COVID-19 Drug Treatments Under Pandemic Circumstances: Results from a Systematic Review
Clazinus Veijer, Marinus H. van Hulst, Benjamin Friedrichson, Maarten J. Postma, Antoinette D.I. van Asselt PharmacoEconomics.2024; 42(6): 633. CrossRef - Economic Evaluation of Nirmatrelvir/Ritonavir Among Adults Against Hospitalization During the Omicron Dominated Period in Malaysia: A Real-World Evidence Perspective
Ee Vien Low, Hoon Shien Teh, Nicholas Yee Liang Hing, Suresh Kumar Chidambaram, Mohan Dass Pathmanathan, Wee Ric Kim, Wei Jia Lee, Zhi Wei Teh, Maheshwara Rao Appannan, Shahanizan Mohd Zin, Faizah Muhamad Zin, Samha Bashirah Mohamed Amin, Mastura Ismail, Drugs - Real World Outcomes.2024; 11(2): 299. CrossRef - Cost-utility analysis of molnupiravir for high-risk, community-based adults with COVID-19: an economic evaluation of the PANORAMIC trial
May Ee Png, Victoria Harris, Jenna Grabey, Nigel D Hart, Bhautesh D Jani, Daniel Butler, Andrew Carson-Stevens, Maria Coates, Lucy Cureton, Melissa Dobson, Jienchi Dorward, Philip Evans, Nick Francis, Oghenekome A Gbinigie, Gail Hayward, Jane Holmes, Kere British Journal of General Practice.2024; 74(745): e570. CrossRef - Cost-effectiveness analysis of COVID-19 vaccination: A review of some vaccination models
Rehana Naz, Andrew Omame, Mariano Torrisi Partial Differential Equations in Applied Mathematics.2024; 11: 100842. CrossRef - Cost-effectiveness analysis of COVID-19 booster doses and oral antivirals: Case studies in the Indo-Pacific
Gizem Mayis Bilgin, Syarifah Liza Munira, Kamalini Lokuge, Kathryn Glass, Dominic Luke Thorrington PLOS ONE.2024; 19(9): e0294091. CrossRef - Impact of the Use of Oral Antiviral Agents on the Risk of Hospitalization in Community Coronavirus Disease 2019 Patients (COVID-19)
Terry Cheuk-Fung Yip, Grace Chung-Yan Lui, Mandy Sze-Man Lai, Vincent Wai-Sun Wong, Yee-Kit Tse, Bosco Hon-Ming Ma, Elsie Hui, Maria K W Leung, Henry Lik-Yuen Chan, David Shu-Cheong Hui, Grace Lai-Hung Wong Clinical Infectious Diseases.2023; 76(3): e26. CrossRef - Nirmatrelvir plus ritonavir in COVID-19: a profile of its use
Hannah A. Blair Drugs & Therapy Perspectives.2023; 39(2): 41. CrossRef - Cost-effectiveness analysis of ritonavir boosted nirmatrelvir for adult outpatients with mild to moderate COVID-19 in a European health system
Philip Wikman-Jorgensen, José María Ibarra, Carlos Devesa, Jorge Peris, Jara Llenas-García European Journal of Internal Medicine.2023; 118: 133. CrossRef - Assessing the cost-effectiveness of annual COVID-19 booster vaccination in South Korea using a transmission dynamic model
Wongyeong Choi, Eunha Shim Frontiers in Public Health.2023;[Epub] CrossRef - Multi-Faceted Analysis of COVID-19 Epidemic in Korea Considering Omicron Variant: Mathematical Modeling-Based Study
Youngsuk Ko, Victoria May Mendoza, Renier Mendoza, Yubin Seo, Jacob Lee, Jonggul Lee, Donghyok Kwon, Eunok Jung Journal of Korean Medical Science.2022;[Epub] CrossRef - Adjusting non-pharmaceutical interventions based on hospital bed capacity using a multi-operator differential evolution
Victoria May P. Mendoza, Renier Mendoza, Jongmin Lee, Eunok Jung AIMS Mathematics.2022; 7(11): 19922. CrossRef - The Possible Impact of Nationwide Vaccination on Outcomes of the COVID-19 Epidemic in North Korea: A Modelling Study
Sung-mok Jung, Jaehun Jung Journal of Korean Medical Science.2022;[Epub] CrossRef -
Medications for early treatment of
COVID
‐19 in Australia
Adam Polkinghorne, James M Branley Medical Journal of Australia.2022;[Epub] CrossRef - Comparative effectiveness of sotrovimab and molnupiravir for prevention of severe covid-19 outcomes in patients in the community: observational cohort study with the OpenSAFELY platform
Bang Zheng, Amelia C A Green, John Tazare, Helen J Curtis, Louis Fisher, Linda Nab, Anna Schultze, Viyaasan Mahalingasivam, Edward P K Parker, William J Hulme, Sebastian C J Bacon, Nicholas J DeVito, Christopher Bates, David Evans, Peter Inglesby, Henry D BMJ.2022; : e071932. CrossRef - Treatment Options for Patients With Mild-to-Moderate Coronavirus Disease 2019 in Korea
Jaehyun Jeon, BumSik Chin Journal of Korean Medical Science.2022;[Epub] CrossRef
|