Retrospective modelling of hospital bed capacities associated with the administration of remdesivir during the first wave of COVID-19 in a German metropolitan city

Abstract

Objectives Internationally, healthcare systems are confronted by an ever-increasing scarcity of medical resources due to the ongoing novel coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to investigate the impact of remdesivir on the demand of hospital bed capacities for hospitalized COVID-19 patients and to evaluate the potentially created capacities for treating additional COVID-19 patients or elective treatments at the hospital. Methods An epidemiological model was developed that utilized the population of Cologne (Germany) during the first COVID-19 wave (first hospitalized patient—30 September 2020) to compare two scenarios: no administration of remdesivir (A) and the administration of remdesivir according to the EMA label (B). The results of the Adaptive COVID-19 Treatment Trial were used to evaluate the potential impact of remdesivir on hospital capacity. Results With the first recorded patient on 2 March 2020, a total of 576 COVID-19 hospitalized patients were detected during the first wave in Cologne. Comparing both scenarios (A versus B) of the model, the administration of remdesivir increased the number of discharges from 259 to 293 (+5.8%) and fewer patients needed ICU admission [214 versus 178 (−6.3%)]. In addition, the model estimated 20 fewer deaths (scenario B). Based on a reduced length of stay, 31.4 hospital beds (57.0 versus 25.6) could have been freed by administering remdesivir to eligible patients. This would have allowed either the treatment of an additional 730 COVID-19 patients or 660 elective treatments. Conclusions In our model, remdesivir administration profoundly contributed to free hospital capacities in the metropolitan city Cologne in Germany.

Remdesivir-related cost-effectiveness and cost and resource use evidence in COVID-19: a systematic review

“…A further cost-consequence study from the perspective of the US [ 54 ] and a cost-effectiveness study from Turkey [ 55 ] have reported that remdesivir would be a cost-effective and strongly dominant treatment for COVID-19, respectively. In addition, epidemiological modelling studies from Germany [ 56 ], South Africa [ 57 ], Saudi Arabia [ 58 ] and Portugal [ 59 ] have reported that remdesivir administration would result in significant increases in hospital bed capacities, while a cohort study in Hong Kong has found that early remdesivir treatment is associated with significantly shorter hospital LOS [ 60 ]. Of note, several of these studies reported reduced ICU LOS or increased ICU bed capacity with remdesivir, in line with Béraud 2020 and Soriano 2021, a notable outcome considering the substantially higher costs associated with ICU stays in comparison with general ward stays [ 32 , 34 ].…”

Anti-SARS-CoV-2 Biotherapeutics and Chemotherapeutics: An Insight into Product Specifications and Marketing Dynamics

“…However, this drug is mainly used for hospitalized severe COVID-19 infected patients. Remdesivir is widely used in the COVID-19 treatment all over the world [38,39] .…”

“…Chemically Remdesivir is a protide (prodrug of nucleotide) broad-spectrum antiviral therapeutic which can diffuse into the cells. The drug mainly interferes with the action of RNA-dependent RNA polymerase and inhibits the RNA polymerase activity [38,39] .…”

“…If the glass particulates enter the blood vessel, they can travel through different organs and block the blood flow, resulting in stroke and even death. The recall has been completed, and US FDA terminated [38,39] .…”

“…The manufacturer Gilead had a tie-up with nine major generic drug makers in Asia. Since the remdesivir is to be administered under medical supervision, the additional hospitalization cost will become an overhead in treatment expenditure [38,39] .…”