在高风险人群中对Nirmatrelvir/Ritonavir治疗COVID-19的成本效益分析:一个建模研究
Emma Birnie1,2,3, Magda Vergouwe1,2, Brent Appelman1,2
1Center for Infection and Molecular Medicine, Amsterdam University Medical Center, Location AMC, University of Amsterdam, Amsterdam, the Netherlands.
Open forum infectious diseases
|April 21, 2025
概括
尼尔马特里尔维尔/里托纳维尔可以减少高风险COVID-19患者的住院和死亡. 这种药物以降低的价格具有成本效益,这表明需要重新评估目前对SARS-CoV-2治疗的定价.
科学领域:
- 药物经济学 药物经济学
- 传染性疾病 传染性疾病
- 健康 结果 研究 研究 结果
背景情况:
- 尼尔马特里尔维尔/里托纳维尔 (nirmatrelvir/r) 是SARS-CoV-2感染高风险个体的关键治疗方法,以预防严重疾病.
- 目前荷兰的nirmatrelvir/r的成本约为1375美元,这引发了对其可访问性和价值的质疑.
- 评估nirmatrelvir/r的健康结果和成本效益对于为治疗指南和药物定价政策提供信息至关重要.
研究的目的:
- 评估与高风险SARS-CoV-2患者的nirmatrelvir/r使用相关的健康结果.
- 在各种有效性场景下确定nirmatrelvir/r的成本效益.
- 为了确定最佳的价格为nirmatrelvir/r被认为是具有成本效益的.
主要方法:
- 使用SARS-CoV-2感染个体的临床和医疗保健利用数据 (2021年9月至2023年11月) 开发了一个决策分析模型.
- 医院住院 (1%) 和ICU入院 (0.05%) 的基线事件率被假定是不同的.
- 从第三方付款人的角度评估了成本效益,每获得的质量调整寿命年门为<88,000美元;进行了敏感性分析.
主要成果:
- 该研究包括949名高风险的SARS-CoV-2患者 (平均年龄65岁,44%为女性),患有各种并发症.
- 尼马特里尔维尔/r显著降低了风险:21%至89%的住院和44%至90%的死亡,这取决于有效性.
- 低于512美元 (低效率) 和1071美元 (高效率) 的价格实现了成本效益,基线事件率更高提高了成本效益.
结论:
- 尼尔马特里尔维尔/r可以减少高风险COVID-19患者的住院和死亡,即使目前的基线事件率较低.
- 药物的成本效益对其价格非常敏感,需要大幅降低 (22-63%),以符合卫生系统的门.
- 这些发现凸显出政策制定者和医生需要重新评估目前用于SARS-CoV-2治疗的nirmatrelvir/r的定价.
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