Impact of oral early antiviral therapies for mild-moderate COVID-19 in the outpatient's setting during Omicron era: a pharmacoeconomic analysis.

Autor: Scaglione V; Infectious and Tropical Diseases Unit, Padua University Hospital, 35128, Padua, Italy. vincenzo.scaglione@aopd.veneto.it., Gardin S; Infectious and Tropical Diseases Unit, Padua University Hospital, 35128, Padua, Italy., Sasset L; Infectious and Tropical Diseases Unit, Padua University Hospital, 35128, Padua, Italy., Presa N; Infectious and Tropical Diseases Unit, Padua University Hospital, 35128, Padua, Italy., Rossetto A; Infectious and Tropical Diseases Unit, Padua University Hospital, 35128, Padua, Italy., Boemo DG; Department of Directional Hospital Management, Padua University Hospital, Padua, Italy., Silvola S; LIUC Business School, LIUC University, Castellanza, VA, Italy., Restelli U; LIUC Business School, LIUC University, Castellanza, VA, Italy., Cattelan A; Infectious and Tropical Diseases Unit, Padua University Hospital, 35128, Padua, Italy.
Jazyk: angličtina
Zdroj: European journal of medical research [Eur J Med Res] 2024 Dec 19; Vol. 29 (1), pp. 597. Date of Electronic Publication: 2024 Dec 19.
DOI: 10.1186/s40001-024-02154-2
Abstrakt: Background: Molnupiravir (MOL) and nirmatrelvir/ritonavir (NIR) decreased mortality and hospital admissions in high-risk patients with mild to moderate COVID-19. Nevertheless, there is a lack of data about the pharmacoeconomic impact of these antivirals in the Omicron era. We conducted a pharmacoeconomic analysis assessing the medical costs of the use of these antivirals compared to those occurred in people who refused the treatment.
Methods: The study included the first 50 patients vaccinated against SARS-CoV-2 of each month who experienced mild to moderate COVID-19 and were consecutively treated with oral antivirals at Padua University Hospital between February 1, 2022, and June 30, 2022. In addition, all consecutive patients who met the criteria for antiviral therapy during this period but opted not to receive treatment were included as control group. The two groups were compared in terms of costs associated with emergency department visits and hospitalizations, which were identified as the primary outcomes of the study.
Results: Nine-hundred-sixty-one patients were analysed, mean age was 67.72 ± 15.19 years and 49% were males. The most prevalent comorbidities were cardiovascular disease (57%), obesity (18) and diabetes mellitus (18%). Two-hundred-fifty-one (26%) patients were treated with MOL (group A), 252/961 (26%) were treated with NIR (group B) and 458/961 (48%) refused antiviral therapy (group C). While a generally more favourable outcomes was observed in the early treated group, no statistically significance differences between hospitalization or emergency department visits were found between group A and C and between group B and C. Total direct medical costs were statistically significantly higher both comparing group A (671.42 ± 460€) vs. group C and comparing group B (1008.42 ± 1562€) vs. group C (446.58 ± 4977€). The main cost driver associated with the increased cost was the antiviral therapy. The average hospitalization cost was 19,334.3 ± 27,030€ for group C, 8956.2 ± 7412€ for group B and 10,267.2€ for group A.
Conclusions: In the context of the Omicron variant during the COVID-19 pandemic, the use of early oral antiviral agents in vaccinated individuals was found to be more expensive compared to avoid treatment, primarily due to the high costs associated with it. To enhance the efficiency in resource allocation, it is essential to pursue policies aimed at reducing drug costs, along with conducting further pharmaco-economic studies.
Competing Interests: Declarations. Ethics approval and consent to participate: Study protocol was approved by Local Ethic Committee (n. AOP 0002323, January 1st, 2022). Each patient was requested to sign written informed consent for participation. Competing interests: A.C. received a research grant from Gilead Sciences, speakers’ honoraria from ViiV Healthcare, Gilead Sciences, and Merck Sharp & Dohme, and advisory board fees from ViiV Healthcare. V.S. received speakers’ honoraria from Angelini. All the other authors do not have any conflicts of interest to disclose.
(© 2024. The Author(s).)
Databáze: MEDLINE
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