Your browser doesn't support javascript.
Treatment of moderate to severe respiratory COVID-19: a cost-utility analysis.
Congly, Stephen E; Varughese, Rhea A; Brown, Crystal E; Clement, Fiona M; Saxinger, Lynora.
  • Congly SE; Division of Gastroenterology and Hepatology, Department of Medicine, Cumming School of Medicine, University of Calgary, 6th Floor, Teaching Research and Wellness Building, 3280 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada. secongly@ucalgary.ca.
  • Varughese RA; O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada. secongly@ucalgary.ca.
  • Brown CE; Division of Pulmonary Medicine, Department of Medicine, University of Alberta, Edmonton, AB, Canada.
  • Clement FM; Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA, USA.
  • Saxinger L; O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada.
Sci Rep ; 11(1): 17787, 2021 09 07.
Article in English | MEDLINE | ID: covidwho-1397899
Preprint
This scientific journal article is probably based on a previously available preprint. It has been identified through a machine matching algorithm, human confirmation is still pending.
See preprint
ABSTRACT
Despite COVID-19's significant morbidity and mortality, considering cost-effectiveness of pharmacologic treatment strategies for hospitalized patients remains critical to support healthcare resource decisions within budgetary constraints. As such, we calculated the cost-effectiveness of using remdesivir and dexamethasone for moderate to severe COVID-19 respiratory infections using the United States health care system as a representative model. A 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 only moderate and only severe 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. Supportive care for moderate/severe COVID-19 cost $11,112.98 with 0.7155 quality adjusted life-year (QALY) obtained. Using dexamethasone for all patients was the most-cost effective with an incremental cost-effectiveness ratio of $980.84/QALY; all remdesivir strategies were more costly and less effective. Probabilistic sensitivity analyses showed dexamethasone for all patients was most cost-effective in 98.3% of scenarios. Dexamethasone for moderate-severe COVID-19 infections was the most cost-effective strategy and would have minimal budget impact. Based on current data, remdesivir is unlikely to be a cost-effective treatment for COVID-19.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Health Care Rationing / Health Care Costs / COVID-19 Type of study: Diagnostic study / Health economic evaluation / Prognostic study Limits: Humans / Middle aged Country/Region as subject: North America Language: English Journal: Sci Rep Year: 2021 Document Type: Article Affiliation country: S41598-021-97259-7

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Health Care Rationing / Health Care Costs / COVID-19 Type of study: Diagnostic study / Health economic evaluation / Prognostic study Limits: Humans / Middle aged Country/Region as subject: North America Language: English Journal: Sci Rep Year: 2021 Document Type: Article Affiliation country: S41598-021-97259-7