Cost-utility analysis of molnupiravir plus usual care versus usual care alone as early treatment for community-based adults with COVID-19 and increased risk of adverse outcomes in the UK PANORAMIC trial
Copyright © 2024, The Authors..
BACKGROUND: The cost-effectiveness of molnupiravir, an oral antiviral for early treatment of SARS-CoV-2, has not been established in vaccinated populations.
AIM: To evaluate the cost-effectiveness of molnupiravir relative to usual care alone among mainly vaccinated community-based people at higher risk of severe outcomes from COVID-19 over six months.
DESIGN AND SETTING: Economic evaluation of the PANORAMIC trial in the UK.
METHOD: A cost-utility analysis that adopted a UK National Health Service and personal social services perspective and a six-month time horizon was performed using PANORAMIC trial data. Cost-effectiveness was expressed in terms of incremental cost per quality-adjusted life year (QALY) gained. Sensitivity and subgroup analyses assessed the impacts of uncertainty and heterogeneity. Threshold analysis explored the price for molnupiravir consistent with likely reimbursement.
RESULTS: In the base case analysis, molnupiravir had higher mean costs of £449 (95% confidence interval [CI] 445 to 453) and higher mean QALYs of 0.0055 (95% CI 0.004 to 0.007) than usual care (mean incremental cost per QALY of £81190). Sensitivity and subgroup analyses showed similar results, except those aged ≥75 years with a 55% probability of being cost-effective at a £30000 per QALY threshold. Molnupiravir would have to be priced around £147 per course to be cost-effective at a £15000 per QALY threshold.
CONCLUSION: Molnupiravir at the current cost of £513 per course is unlikely to be cost-effective relative to usual care over a six-month time horizon among mainly vaccinated COVID-19 patients at increased risk of adverse outcomes, except those aged ≥75 years.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
The British journal of general practice : the journal of the Royal College of General Practitioners - (2024) vom: 16. Jan. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Png, May Ee [VerfasserIn] |
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Date Revised 20.03.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.3399/BJGP.2023.0444 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM367189070 |
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| 100 | 1 | |a Png, May Ee |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Cost-utility analysis of molnupiravir plus usual care versus usual care alone as early treatment for community-based adults with COVID-19 and increased risk of adverse outcomes in the UK PANORAMIC trial |
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| 500 | |a Date Revised 20.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Copyright © 2024, The Authors. | ||
| 520 | |a BACKGROUND: The cost-effectiveness of molnupiravir, an oral antiviral for early treatment of SARS-CoV-2, has not been established in vaccinated populations | ||
| 520 | |a AIM: To evaluate the cost-effectiveness of molnupiravir relative to usual care alone among mainly vaccinated community-based people at higher risk of severe outcomes from COVID-19 over six months | ||
| 520 | |a DESIGN AND SETTING: Economic evaluation of the PANORAMIC trial in the UK | ||
| 520 | |a METHOD: A cost-utility analysis that adopted a UK National Health Service and personal social services perspective and a six-month time horizon was performed using PANORAMIC trial data. Cost-effectiveness was expressed in terms of incremental cost per quality-adjusted life year (QALY) gained. Sensitivity and subgroup analyses assessed the impacts of uncertainty and heterogeneity. Threshold analysis explored the price for molnupiravir consistent with likely reimbursement | ||
| 520 | |a RESULTS: In the base case analysis, molnupiravir had higher mean costs of £449 (95% confidence interval [CI] 445 to 453) and higher mean QALYs of 0.0055 (95% CI 0.004 to 0.007) than usual care (mean incremental cost per QALY of £81190). Sensitivity and subgroup analyses showed similar results, except those aged ≥75 years with a 55% probability of being cost-effective at a £30000 per QALY threshold. Molnupiravir would have to be priced around £147 per course to be cost-effective at a £15000 per QALY threshold | ||
| 520 | |a CONCLUSION: Molnupiravir at the current cost of £513 per course is unlikely to be cost-effective relative to usual care over a six-month time horizon among mainly vaccinated COVID-19 patients at increased risk of adverse outcomes, except those aged ≥75 years | ||
| 650 | 4 | |a Journal Article | |
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| 650 | 4 | |a cost-effective | |
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| 700 | 1 | |a Harris, Victoria |e verfasserin |4 aut | |
| 700 | 1 | |a Grabey, Jenna |e verfasserin |4 aut | |
| 700 | 1 | |a Hart, Nigel David |e verfasserin |4 aut | |
| 700 | 1 | |a Jani, Bhautesh Dinesh |e verfasserin |4 aut | |
| 700 | 1 | |a Butler, Daniel |e verfasserin |4 aut | |
| 700 | 1 | |a Carson-Stevens, Andrew |e verfasserin |4 aut | |
| 700 | 1 | |a Coates, Maria |e verfasserin |4 aut | |
| 700 | 1 | |a Cureton, Lucy |e verfasserin |4 aut | |
| 700 | 1 | |a Dobson, Melissa |e verfasserin |4 aut | |
| 700 | 1 | |a Dorward, Jienchi |e verfasserin |4 aut | |
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| 700 | 1 | |a Khoo, Saye |e verfasserin |4 aut | |
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| 700 | 1 | |a Mort, Sam |e verfasserin |4 aut | |
| 700 | 1 | |a Nguyen-Van-Tam, Jonathan |e verfasserin |4 aut | |
| 700 | 1 | |a Rahman, Najib |e verfasserin |4 aut | |
| 700 | 1 | |a Richards, Duncan B |e verfasserin |4 aut | |
| 700 | 1 | |a Thomas, Nicholas |e verfasserin |4 aut | |
| 700 | 1 | |a van Hecke, Oliver |e verfasserin |4 aut | |
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