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A cost-effectiveness framework for evaluation of potential COVID-19 therapies which includes societal costs and post-discharge outcomes shows that treatments which reduce mortality are likely to be cost effective in the US, say authors of a Genentech-funded study published in Advances in Therapy.
A short-term acute-care decision tree followed by a post-discharge Markov model, populated with data on inpatient care, use of mechanical ventialtion and post-discharge ventilator-related morbidity from phase III trials, was used to evaluate the cost effectiveness of a potential treatment in patients hospitalised with COVID-19, compared with best supportive care (BSC), from US health payer, societal and fee-for-service (FFS) payment perspectives over a lifetime time horizon. Drugs were assumed to cost $2500Footnote 1 for a single course of treatment.
Overall, treatments which conferred at least a mortality benefit were likely to be cost effective, with estimated incremental cost-effectiveness ratios (ICERs) well below US willingness-to-pay (WTP) thresholds from health payer and FFS payment perspectives, with and without the inclusion of societal costs.
In base-case analysis, potential COVID-19 therapy was estimated to gain 0.438 incremental QALYs compared with BSC, and was estimated to result in ICERs of $22 933 per QALY gained from a health payer perspective using bundled payments, $11 492 per QALY gained from a societal perspective, $19 469 per QALY gained from the FFS payment perspective, and $8028 per QALY gained from the FFS perspective when the societal impact was included.
Sensitivity analyses found that inclusion of societal costs produced ICERs 40%−60% lower than ICERs estimated from the payer perspective, even under conservative assumptions.
"Effective COVID-19 treatments for hospitalized patients may not only reduce disease burden but also represent good value for the health system . . . despite limited data available on the long-term impact of invasive mechanical ventilation and productivity of COVID-19 patients post-discharge, it is possible to estimate the cost-effectiveness of inpatient treatments for COVID-19 from a societal perspective using a conservative approach to help guide future decisions on allocation of healthcare resources," concluded the authors.
Notes
2020 US dollars
Reference
Sheinson D, et al. A Cost-Effectiveness Framework for COVID-19 Treatments for Hospitalized Patients in the United States. Advances in Therapy : 27 Feb 2021. Available from: URL: http://doi.org/10.1007/s12325-021-01654-5
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Cost-effectiveness framework for evaluating COVID-19 therapies. PharmacoEcon Outcomes News 874, 12 (2021). https://doi.org/10.1007/s40274-021-7555-9
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DOI: https://doi.org/10.1007/s40274-021-7555-9