Cost-Effectiveness Analysis of Remdesivir Treatment in COVID-19 Patients Requiring Low-Flow Oxygen Therapy: Payer Perspective in Turkey

Abstract

Introduction This study aims to evaluate the cost-effectiveness of remdesivir compared to other existing therapies (SoC) in Turkey to treat COVID-19 patients hospitalized with < 94% saturation and low-flow oxygen therapy (LFOT) requirement. Methods We compared remdesivir as the treatment for COVID-19 with the treatments in the Turkish treatment guidelines. Analyses were performed using data from 78 hospitalized COVID-19 patients with SpO 2 < 94% who received LFOT in a tertiary healthcare facility. COVID-19 episode costs were calculated for 78 patients considering the cost of modeled remdesivir treatment in the same group from the payer’s perspective. The incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year (QALY) was calculated for remdesivir versus the SoC for the population identified. For Turkey, a reimbursement threshold value between USD 8599 (1 × per capita gross domestic product—GDP) and USD 25.797 (3 × GDP) per QALY was used. Results In the remdesivir arm, the length of hospital stay (LOS) was 3 days shorter than the SOC. The low ventilator requirement in the remdesivir arm was one factor that decreased the QALY disutility value. In patients who were transferred to intensive care unit (ICU) from the ward, the mean LOS was 17.3 days (SD 13.6), and the mean cost of stay was USD 155.3/day (SD 168.0), while in patients who were admitted to ICU at baseline, the mean LOS was 13.1 days (SD 13.7), and the mean cost of stay was USD 207.9/day (SD 133.6). The mean cost of episode per patient was USD 3461.1 (SD 2259.8) in the remdesivir arm and USD 3538.9 (SD 3296.0) in the SOC arm. Incremental QALYs were estimated at 0.174. Remdesivir treatment was determined to be cost saving vs. SoC. Conclusions Remdesivir, which results in shorter LOS and lower rates of intubation requirements in ICU patients than existing therapies, is associated with higher QALYs and lower costs, dominating SoC in patients with SpO 2 < 94% who require oxygen support. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-021-01874-9.

ICU-Associated Costs during the Fourth Wave of the COVID-19 Pandemic in a Tertiary Hospital in a Low-Vaccinated Eastern European Country

“…However, the authors did not provide any details related to the type of costs included so that we cannot say if these higher costs are attributed to a higher medication cost or to the addition of supplemental costs such as personnel costs. In a similar study published by Oksuz et al [32], the authors reported the same treatment protocol as that applied in our cohort with a mean medication cost of ICU patients of USD 207.9 per day and a mean total patient cost of USD 3461.1. The difference between this study and ours can be explained by the added cost of immunomodulatory therapy and medical-device-related costs that were not reported in the Turkish cohort, although the same antiviral therapy, a major determinant of cost increasement in our study, was used in both the Romanian and Turkish cohorts.…”

Modeling the Potential Impact of Remdesivir Treatment for Hospitalized Patients with COVID-19 in Saudi Arabia on Healthcare Resource Use and Direct Hospital Costs: A Hypothetical Study

“…In addition, several other countries have used similar models to estimate the impact of treating patients with remdesivir on healthcare resource use and overall costs to the healthcare system [25][26][27][28]. The findings from the Italian and Portuguese studies are similar to what was found with this model, indicating that these results can be generalizable across geographies experiencing similar infection and hospitalization rates.…”

Cost-effectiveness of remdesivir plus usual care versus usual care alone for hospitalized patients with COVID-19: an economic evaluation as part of the Canadian Treatments for COVID-19 (CATCO) randomized clinical trial

“…[1][2][3]6 These findings are consistent with cost-effectiveness analyses of remdesivir in the literature from other jurisdictions and studies using model-based designs. [7][8][9] Despite similar mean and median hospital length of stay in the 2 arms of CATCO, 6 there were meaningful reductions in the remdesivir group for both new need for mechanical ventilation and total days in ICU. The additional time in ICU for patients receiving usual care only was the largest incremental cost driver.…”

“…6 There are substantial drug acquisition costs for remdesivir; therefore, a health economic evaluation is an important component in health care system decision-making for its use. Other jurisdictions have showed cost-effectiveness or dominance of remdesivir compared with supportive care, 7 although most studies were model-based. 8,9 We conducted a cost-effectiveness analysis (E-CATCO) alongside the CATCO trial assessing remdesivir plus usual care versus usual care alone by measuring health care resource utilization and costs and clinical outcomes in the 2 treatment arms for hospitalized adults with COVID-19.…”