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Cost-utility analysis of molnupiravir for high-risk, community-based adults with COVID-19: an economic evaluation of the PANORAMIC trial.
Png, May Ee; Harris, Victoria; Grabey, Jenna; Hart, Nigel D; Jani, Bhautesh D; Butler, Daniel; Carson-Stevens, Andrew; Coates, Maria; Cureton, Lucy; Dobson, Melissa; Dorward, Jienchi; Evans, Philip; Francis, Nick; Gbinigie, Oghenekome A; Hayward, Gail; Holmes, Jane; Hood, Kerenza; Khoo, Saye; Ahmed, Haroon; Lown, Mark; McKenna, Micheal; Mort, Sam; Nguyen-Van-Tam, Jonathan S; Rahman, Najib M; Richards, Duncan B; Thomas, Nicholas Pb; van Hecke, Oliver; Hobbs, Richard; Little, Paul; Yu, Ly-Mee; Butler, Christopher C; Petrou, Stavros.
Afiliación
  • Png ME; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
  • Harris V; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
  • Grabey J; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
  • Hart ND; Dentistry and Biomedical Sciences, Queen's University Belfast, UK.
  • Jani BD; General Practice and Primary Care, School of Health and Wellbeing, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow.
  • Butler D; Dentistry and Biomedical Sciences, Queen's University Belfast, UK.
  • Carson-Stevens A; Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK.
  • Coates M; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
  • Cureton L; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
  • Dobson M; Oxford Respiratory Trials Unit, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
  • Dorward J; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK; Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa.
  • Evans P; Faculty of Health and Life Sciences, University of Exeter, Exeter, UK; National Institute for Health and Care Research (NIHR) Clinical Research Network, University of Leeds, Leeds, UK.
  • Francis N; Primary Care Research Centre, University of Southampton, Southampton, UK.
  • Gbinigie OA; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
  • Hayward G; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
  • Holmes J; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
  • Hood K; Centre for Trials Research, Cardiff University, Cardiff, UK.
  • Khoo S; Department of Pharmacology, University of Liverpool, Liverpool, UK.
  • Ahmed H; Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK.
  • Lown M; Primary Care Research Centre, University of Southampton, Southampton, UK.
  • McKenna M; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
  • Mort S; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
  • Nguyen-Van-Tam JS; Lifespan and Population Health Unit, School of Medicine, University of Nottingham, Nottingham, UK.
  • Rahman NM; Oxford Respiratory Trials Unit, Nuffield Department of Medicine, University of Oxford, Oxford; Oxford NIHR Biomedical Research Centre, Oxford; Chinese Academy of Medicial Sciences Oxford Institute, University of Oxford, Oxford, UK.
  • Richards DB; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
  • Thomas NP; Witney; NIHR Thames Valley and South Midlands Clinical Research Network, UK; Royal College of General Practitioners, London, UK.
  • van Hecke O; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
  • Hobbs R; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
  • Little P; Primary Care Research Centre, University of Southampton, Southampton, UK.
  • Yu LM; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
  • Butler CC; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
  • Petrou S; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Br J Gen Pract ; 74(745): e570-e579, 2024 Aug.
Article en En | MEDLINE | ID: mdl-38228357
ABSTRACT

BACKGROUND:

The cost-effectiveness of molnupiravir, an oral antiviral for early treatment of SARS-CoV-2, has not been established in vaccinated populations.

AIM:

To evaluate the cost-effectiveness of molnupiravir relative to usual care alone among mainly vaccinated community-based people at higher risk of severe outcomes from COVID-19 over 6 months. DESIGN AND

SETTING:

An economic evaluation of the PANORAMIC trial in the UK.

METHOD:

A cost-utility analysis that adopted a UK NHS and personal social services perspective and a 6-month time horizon was performed using PANORAMIC trial data. Cost-effectiveness was expressed in terms of incremental cost per quality-adjusted life year (QALY) gained. Sensitivity and subgroup analyses assessed the impacts of uncertainty and heterogeneity. Threshold analysis explored the price for molnupiravir consistent with likely reimbursement.

RESULTS:

In the base-case analysis, molnupiravir had higher mean costs of £449 (95% confidence interval [CI] = 445 to 453) and higher mean QALYs of 0.0055 (95% CI = 0.0044 to 0.0067) than usual care (mean incremental cost per QALY of £81 190). Sensitivity and subgroup analyses showed similar results, except for those aged ≥75 years, with a 55% probability of being cost-effective at a £30 000 per QALY threshold. Molnupiravir would have to be priced around £147 per course to be cost-effective at a £15 000 per QALY threshold.

CONCLUSION:

At the current cost of £513 per course, molnupiravir is unlikely to be cost-effective relative to usual care over a 6-month time horizon among mainly vaccinated patients with COVID-19 at increased risk of adverse outcomes, except those aged ≥75 years.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Antivirales / Análisis Costo-Beneficio / Años de Vida Ajustados por Calidad de Vida / Citidina / SARS-CoV-2 / Tratamiento Farmacológico de COVID-19 / Hidroxilaminas Tipo de estudio: Etiology_studies / Health_economic_evaluation / Risk_factors_studies Aspecto: Patient_preference Límite: Adult / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Br J Gen Pract Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Antivirales / Análisis Costo-Beneficio / Años de Vida Ajustados por Calidad de Vida / Citidina / SARS-CoV-2 / Tratamiento Farmacológico de COVID-19 / Hidroxilaminas Tipo de estudio: Etiology_studies / Health_economic_evaluation / Risk_factors_studies Aspecto: Patient_preference Límite: Adult / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Br J Gen Pract Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Reino Unido