Model-based cost-effectiveness analysis of oral antivirals against SARS-CoV-2 in Korea

Jo Youngji; Kim Sun Bean; Radnaabaatar Munkhzul; Huh Kyungmin; Yoo Jin-Hong; Peck Kyong Ran; Park Hojun; 정재훈

doi:10.4178/epih.e2022034

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자료유형: 학술저널

저자정보: Jo Youngji (Section of Infectious Disease Department of Medicine Boston Medical Center Boston MA USA.) Kim Sun Bean (Division of Infectious Diseases Department of Internal Medicine Korea University Anam Hospital Kore) Radnaabaatar Munkhzul (Artificial Intelligence and Big-Data Convergence Center Gil Medical Center Gachon University Colleg) Huh Kyungmin (Division of Infectious Diseases Department of Internal Medicine Samsung Medical Center Sungkyunkwan) Yoo Jin-Hong (Division of Infectious Diseases Department of Internal Medicine Bucheon St. Mary's Hospital Bucheon) Peck Kyong Ran (Department of Internal Medicine Samsung Medical Center Sungkyunkwan University School of Medicine S) Park Hojun (Artificial Intelligence and Big-Data Convergence Center Gil Medical Center Gachon University Colleg) 정재훈 (가천대학교)

저널정보: 한국역학회 Epidemiology and Health Epidemiology and Health Vol.44

발행연도: 2022.1

수록면: 1 - 10 (10page)

DOI: 10.4178/epih.e2022034

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OBJECTIVES: Many countries have authorized the emergency use of oral antiviral agents for patients with mild-to-moderate cases of coronavirus disease 2019 (COVID-19). We assessed the cost-effectiveness of these agents for reducing the number of severe COVID-19 cases and the burden on Korea’s medical system. METHODS: Using an existing model, we estimated the number of people who would require hospital/intensive care unit (ICU) admission in Korea in 2022. The treatment scenarios included (1) all adult patients, (2) elderly patients only, and (3) adult patients with underlying diseases only, compared to standard care. Based on the current health system capacity, we calculated the incremental costs per severe case averted and hospital admission for each scenario. RESULTS: We estimated that 236,510 COVID-19 patients would require hospital/ICU admission in 2022 with standard care only. Nirmatrelvir/ritonavir (87% efficacy) was predicted to reduce this number by 80%, 24%, and 17% when targeting all adults, adults with underlying diseases, and elderly patients (25, 8, and 4%, respectively, for molnupiravir, with 30% efficacy). Nirmatrelvir/ritonavir use is likely to be cost-effective, with predicted costs of US$8,878, US$8,964, and US$1,454, per severe patient averted for the target groups listed above, respectively, while molnupiravir is likely to be less cost-effective, with costs of US$28,492, US$29,575, and US$7,915, respectively. CONCLUSIONS: In Korea, oral treatment using nirmatrelvir/ritonavir for symptomatic COVID-19 patients targeting elderly patients would be highly cost-effective and would substantially reduce the demand for hospital admission to below the capacity of the health system if targeted to all adult patients instead of standard care.

#SARS-CoV-2 #Cost-effectiveness analysis #Antiviral agents #COVID-19 #Hospitalization

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Jo Youngji

소속기관 Section of Infectious Disease Department of Medicine Boston Medical Center Boston MA USA.

주요연구분야 의약학 > 기초의학 > 예방의학·직업환경의학

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Kim Sun Bean

소속기관 Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.