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Epidemiol Health > Volume 44; 2022 > Article
Epidemiology and Health 2022;44: e2022034-0.
DOI: https://doi.org/10.4178/epih.e2022034    Published online Mar 12, 2022.
Model-based cost-effectiveness analysis of oral antivirals against SARS-CoV-2 in Korea
Youngji Jo1  , Sun Bean Kim2  , Munkhzul Radnaabaatar3  , Kyungmin Huh4  , Jin-Hong Yoo5  , Kyong Ran Peck4  , Hojun Park3,6  , Jaehun Jung3,6,7 
1Section of Infectious Disease, Department of Medicine, Boston Medical Center, Boston, MA, USA
2Department of Internal Medicine, Division of Infectious Diseases, Korea University College of Medicine, Seoul, Korea
3Artificial Intelligence and Big-Data Convergence Center, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
4Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
5Division of Infectious Diseases, Department of Internal Medicine, Bucheon St. Mary’s Hospital, Bucheon, Korea
6Division of Infectious Diseases, Department of Internal Medicine, Bucheon St. Mary’s Hospital, Bucheon, Korea
7Prime Minister’s Secretariat, Seoul, Korea
Correspondence  Jaehun Jung ,Email: eastside1st@gmail.com
Received: Feb 7, 2022  Accepted after revision: Mar 12, 2022
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.
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.
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.
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.
Keywords: SARS-CoV-2, Cost-effectiveness analysis, Antiviral agents, COVID-19, Hospitalization
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