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Remdesivir-related cost-effectiveness and cost and resource use evidence in COVID-19: a systematic review
Molly Murton1, Emma Drane2, James Jarrett3
1Costello Medical, London, UK.
Insights
This review of remdesivir for COVID-19 found it to be cost-effective in most evaluations. Remdesivir use increased over time, reducing hospital bed occupancy and aiding healthcare systems during the pandemic.
Area of Science:
- Health Economics
- Pharmacoeconomics
- Infectious Disease Management
Background:
- The COVID-19 pandemic created significant global health and economic challenges.
- Remdesivir is the sole FDA-approved treatment for severe COVID-19 as of February 2022.
- This study systematically reviews economic evaluations and cost/resource use of remdesivir during the pandemic.
Approach:
- Searched multiple databases (MEDLINE, Embase, HTA) and grey literature in May 2021.
- Two independent reviewers assessed article relevance and study quality.
- Synthesized findings from eight studies on resource use and five on costs.
Key Points:
- Remdesivir prescription rates and timeliness of initiation increased over time.
- Associated with a 6%–21.3% reduction in hospital bed occupancy.
- Cost-effectiveness analyses indicated favorable outcomes, with treatment costs ranging from 8%–23% of willingness-to-pay thresholds.
Conclusions:
- Economic evidence for remdesivir should consider clinical context, patient characteristics, and administration timing.
- Remdesivir remains a vital therapeutic option for optimizing patient care.
- It helps alleviate healthcare system pressures during the evolving pandemic.
Background:
The coronavirus disease 2019 (COVID-19) pandemic has been a global health emergency since December 2019, leading to millions of deaths worldwide and placing significant pressures, including economic burden, on individual patients and healthcare systems. As of February 2022, remdesivir is the only US Food and Drug Administration (FDA)-approved treatment for severe COVID-19. This systematic literature review (SLR) aimed to summarise economic evaluations, and cost and resource use (CRU) evidence related to remdesivir during the COVID-19 pandemic.
Methods:
Searches of MEDLINE, Embase the International Health Technology Assessment (HTA) database, reference lists, congresses and grey literature were performed in May 2021. Articles were reviewed for relevance against pre-specified criteria by two independent reviewers and study quality was assessed using published checklists.
Results:
Eight studies reported resource use and five reported costs related to remdesivir. Over time, the prescription rate of remdesivir increased and time from disease onset to remdesivir initiation decreased. Remdesivir was associated with a 6% to 21.3% decrease in bed occupancy. Cost estimates for remdesivir ranged widely, from $10 to $780 for a 10-day course. In three out of four included economic evaluations, remdesivir treatment scenarios were cost-effective, ranging from ~ 8 to ~ 23% of the willingness-to-pay threshold for the respective country.
Conclusions:
Economic evidence relating to remdesivir should be interpreted with consideration of the broader clinical context, including patients' characteristics and the timing of its administration. Nonetheless, remdesivir remains an important option for physicians in aiming to provide optimal care and relieve pressure on healthcare systems through shifting phases of the pandemic.
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