Treatment of moderate to severe respiratory COVID-19: a cost-utility analysis

Abstract Despite COVID-19’s significant morbidity and mortality, considering cost-effectiveness of pharmacologic treatment strategies for hospitalized patients remains critical to support healthcare resource decisions within budgetary constraints. As such, we calculated the cost-effectiveness of usi...

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Autores principales:	Stephen E. Congly, Rhea A. Varughese, Crystal E. Brown, Fiona M. Clement, Lynora Saxinger
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/039dc49a0d224b6b8e76c629176974fd
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spelling	oai:doaj.org-article:039dc49a0d224b6b8e76c629176974fd2021-12-02T14:58:47ZTreatment of moderate to severe respiratory COVID-19: a cost-utility analysis10.1038/s41598-021-97259-72045-2322https://doaj.org/article/039dc49a0d224b6b8e76c629176974fd2021-09-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-97259-7https://doaj.org/toc/2045-2322Abstract Despite COVID-19’s significant morbidity and mortality, considering cost-effectiveness of pharmacologic treatment strategies for hospitalized patients remains critical to support healthcare resource decisions within budgetary constraints. As such, we calculated the cost-effectiveness of using remdesivir and dexamethasone for moderate to severe COVID-19 respiratory infections using the United States health care system as a representative model. A decision analytic model modelled a base case scenario of a 60-year-old patient admitted to hospital with COVID-19. Patients requiring oxygen were considered moderate severity, and patients with severe COVID-19 required intubation with intensive care. Strategies modelled included giving remdesivir to all patients, remdesivir in only moderate and only severe infections, dexamethasone to all patients, dexamethasone in severe infections, remdesivir in moderate/dexamethasone in severe infections, and best supportive care. Data for the model came from the published literature. The time horizon was 1 year; no discounting was performed due to the short duration. The perspective was of the payer in the United States health care system. Supportive care for moderate/severe COVID-19 cost $11,112.98 with 0.7155 quality adjusted life-year (QALY) obtained. Using dexamethasone for all patients was the most-cost effective with an incremental cost-effectiveness ratio of $980.84/QALY; all remdesivir strategies were more costly and less effective. Probabilistic sensitivity analyses showed dexamethasone for all patients was most cost-effective in 98.3% of scenarios. Dexamethasone for moderate-severe COVID-19 infections was the most cost-effective strategy and would have minimal budget impact. Based on current data, remdesivir is unlikely to be a cost-effective treatment for COVID-19.Stephen E. ConglyRhea A. VarugheseCrystal E. BrownFiona M. ClementLynora SaxingerNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Stephen E. Congly Rhea A. Varughese Crystal E. Brown Fiona M. Clement Lynora Saxinger Treatment of moderate to severe respiratory COVID-19: a cost-utility analysis
description	Abstract Despite COVID-19’s significant morbidity and mortality, considering cost-effectiveness of pharmacologic treatment strategies for hospitalized patients remains critical to support healthcare resource decisions within budgetary constraints. As such, we calculated the cost-effectiveness of using remdesivir and dexamethasone for moderate to severe COVID-19 respiratory infections using the United States health care system as a representative model. A decision analytic model modelled a base case scenario of a 60-year-old patient admitted to hospital with COVID-19. Patients requiring oxygen were considered moderate severity, and patients with severe COVID-19 required intubation with intensive care. Strategies modelled included giving remdesivir to all patients, remdesivir in only moderate and only severe infections, dexamethasone to all patients, dexamethasone in severe infections, remdesivir in moderate/dexamethasone in severe infections, and best supportive care. Data for the model came from the published literature. The time horizon was 1 year; no discounting was performed due to the short duration. The perspective was of the payer in the United States health care system. Supportive care for moderate/severe COVID-19 cost $11,112.98 with 0.7155 quality adjusted life-year (QALY) obtained. Using dexamethasone for all patients was the most-cost effective with an incremental cost-effectiveness ratio of $980.84/QALY; all remdesivir strategies were more costly and less effective. Probabilistic sensitivity analyses showed dexamethasone for all patients was most cost-effective in 98.3% of scenarios. Dexamethasone for moderate-severe COVID-19 infections was the most cost-effective strategy and would have minimal budget impact. Based on current data, remdesivir is unlikely to be a cost-effective treatment for COVID-19.
format	article
author	Stephen E. Congly Rhea A. Varughese Crystal E. Brown Fiona M. Clement Lynora Saxinger
author_facet	Stephen E. Congly Rhea A. Varughese Crystal E. Brown Fiona M. Clement Lynora Saxinger
author_sort	Stephen E. Congly
title	Treatment of moderate to severe respiratory COVID-19: a cost-utility analysis
title_short	Treatment of moderate to severe respiratory COVID-19: a cost-utility analysis
title_full	Treatment of moderate to severe respiratory COVID-19: a cost-utility analysis
title_fullStr	Treatment of moderate to severe respiratory COVID-19: a cost-utility analysis
title_full_unstemmed	Treatment of moderate to severe respiratory COVID-19: a cost-utility analysis
title_sort	treatment of moderate to severe respiratory covid-19: a cost-utility analysis
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/039dc49a0d224b6b8e76c629176974fd
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Treatment of moderate to severe respiratory COVID-19: a cost-utility analysis

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