Clinical and economic benefits of lenzilumab plus standard of care compared with standard of care alone for the treatment of hospitalized patients with Coronavirus Disease 19 (COVID-19) from the perspective of National Health Service England (preprint)

Purpose: Estimate the clinical and economic benefits of lenzilumab plus standard of care (SOC) compared with SOC alone in the treatment of hospitalized COVID-19 patients from the National Health Service (NHS) England perspective. Methods: A cost calculator was developed to estimate the clinical benefits and costs of adding lenzilumab to SOC in newly hospitalized COVID-19 patients over 28 days. The LIVE-AIR trial results informed the clinical inputs: failure to achieve survival without ventilation (SWOV), mortality, time to recovery, intensive care unit (ICU) admission, and invasive mechanical ventilation (IMV) use. Base case costs included drug acquisition and administration for lenzilumab and remdesivir and hospital resource costs based on level of care required. Clinical and economic benefits per weekly cohort of newly hospitalized patients were also estimated. Results: In all populations examined, specified clinical outcomes were improved with lenzilumab plus SOC over SOC treatment alone. In a base case population aged <85 years with C-reactive protein (CRP) <150 mg/L, with or without remdesivir, adding lenzilumab to SOC was estimated to result in per patient cost savings of 1,162 British Pounds (GBP). In a weekly cohort of 4,754 newly hospitalized patients, addition of lenzilumab to SOC could result in 599 IMV uses avoided, 352 additional lives saved, and over 5.5 million GBP in cost savings. Scenario results for per-patient cost savings included: 1) aged <85 years, CRP <150 mg/L, and receiving remdesivir (3,127 GBP); 2) Black patients with CRP <150 mg/L (9,977 GBP); and 3) Black patients from the full population (2,369 GBP). Conversely, in the full mITT population, results estimated additional cost of 4,005 GBP per patient. Conclusion: Findings support clinical benefits for SWOV, mortality, time to recovery, time in ICU, time on IMV, and ventilator use, and an economic benefit from the NHS England perspective when adding lenzilumab to SOC for hospitalized COVID-19 patients.

Clinical Benefits and Budget Impact of Lenzilumab plus Standard of Care Compared with Standard of Care Alone for the Treatment of Hospitalized Patients with COVID-19 in the United States from the Hospital Perspective (preprint)

Aims: The study estimated the clinical benefits and budget impact of lenzilumab plus standard of care (SOC) compared with SOC alone in the treatment of hospitalized COVID-19 patients from the United States hospital perspective. Materials and Methods: An economic model was developed to estimate the clinical benefits and costs for an average newly hospitalized COVID-19 patient, with a 28-day time horizon for the index hospitalization. Clinical outcomes from the LIVE-AIR trial included failure to achieve survival without ventilation (SWOV), mortality, time to recovery, intensive care unit (ICU) admission, and invasive mechanical ventilation (IMV) use. Base case costs included drug acquisition and administration for lenzilumab and hospital resource costs based on the level of care required. The inclusion of 1-year rehospitalization costs was examined in a scenario analysis. Results: In the base case and all scenarios, treatment with lenzilumab plus SOC improved all specified clinical outcomes over SOC alone. Adding lenzilumab to SOC was also estimated to result in cost savings of $3,190 per patient in a population aged <85 years with CRP <150 mg/L and receiving remdesivir (base case). Per-patient cost savings were also estimated in the following scenarios: 1) aged <85 years with CRP <150 mg/L, with or without remdesivir ($1,858); 2) Black and African American patients with CRP <150 mg/L ($13,154); and 3) Black and African American patients from the full population ($2,763). In the full mITT population, a budget impact of $4,952 was estimated. When adding rehospitalization costs to the index hospitalization, a total per-patient cost savings of $5,154 was estimated. Conclusions: The results highlight the clinical benefits for SWOV, ventilator use, time to recovery, mortality, time in ICU, and time on IMV, in addition to a favorable budget impact from the United States hospital perspective associated with adding lenzilumab to SOC for patients with COVID-19 pneumonia.