Treatment of moderate to severe respiratory COVID-19: a cost-utility analysis
Autor: | Rhea Varughese, Stephen E. Congly, Lynora Saxinger, Fiona Clement, Crystal E. Brown |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Cost effectiveness
medicine.medical_treatment Cost-Benefit Analysis Severity of Illness Index Dexamethasone Antimicrobial therapy Health care rationing Health care Intubation Respiratory system health care economics and organizations Alanine Health Care Rationing Multidisciplinary Cost–benefit analysis Health Care Costs Health care economics Middle Aged Intensive Care Units Treatment Outcome Infectious diseases Medicine Quality-Adjusted Life Years medicine.drug medicine.medical_specialty Coronavirus disease 2019 (COVID-19) Science Clinical Decision-Making Article Intensive care Severity of illness medicine Humans Computer Simulation Respiratory tract diseases Cost–utility analysis SARS-CoV-2 business.industry COVID-19 Respiration Artificial Adenosine Monophosphate United States COVID-19 Drug Treatment Quality-adjusted life year Oxygen Emergency medicine business |
Zdroj: | Scientific Reports, Vol 11, Iss 1, Pp 1-7 (2021) Scientific Reports |
ISSN: | 2045-2322 |
Popis: | BackgroundDue to COVID-19’s significant morbidity and mortality, identifying the most cost-effective pharmacologic treatment strategy is critical. As such, we determined the most cost-effective strategy for moderate to severe COVID-19 respiratory infections using the United States health care system as a representative model.MethodsA decision analytic model modelled a base case scenario of a 60-year-old patient admitted to hospital with COVID-19. Patients requiring oxygen were considered moderate severity, and patients with severe COVID-19 required intubation with intensive care. Strategies modelled included giving remdesivir to all patients, remdesivir in severe infections, remdesivir in moderate infections, dexamethasone to all patients, dexamethasone in severe infections, remdesivir in moderate/dexamethasone in severe infections, and best supportive care. Data for the model came from the published literature. The time horizon was 1 year; no discounting was performed due to the short duration. The perspective was of the payer in the United States health care system.ResultsSupportive care for moderate/severe COVID-19 cost $11,112.98/0.8256 QALY. Remdesivir in moderate/dexamethasone in severe infections was the most cost-effective with an incremental cost-effectiveness ratio of $19,764.56/QALY gained compared to supportive care. Probabilistic sensitivity analyses showed remdesivir for moderate/dexamethasone for severe COVID-19 infection was most cost-effective in 88.6% of scenarios and dexamethasone in moderate-severe infections in 11.4% of scenarios. With lower willingness to pay thresholds ($250-$37,500), dexamethasone for severe infections was favoured.ConclusionsRemdesivir for moderate/dexamethasone for severe COVID-19 infections was the0020most cost-effective strategy. Further data is required for remdesivir to better assess its cost effectiveness in treatment of COVID-19. |
Databáze: | OpenAIRE |
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