Introduction

This study aims to evaluate the cost-effectiveness of remdesivir compared to other existing therapies (SoC) in Turkey to treat COVID-19 patients hospitalized with < 94% saturation and low-flow oxygen therapy (LFOT) requirement.

Methods

We compared remdesivir as the treatment for COVID-19 with the treatments in the Turkish treatment guidelines. Analyses were performed using data from 78 hospitalized COVID-19 patients with SpO₂ < 94% who received LFOT in a tertiary healthcare facility. COVID-19 episode costs were calculated for 78 patients considering the cost of modeled remdesivir treatment in the same group from the payer’s perspective. The incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year (QALY) was calculated for remdesivir versus the SoC for the population identified. For Turkey, a reimbursement threshold value between USD 8599 (1 × per capita gross domestic product—GDP) and USD 25.797 (3 × GDP) per QALY was used.

Results

In the remdesivir arm, the length of hospital stay (LOS) was 3 days shorter than the SOC. The low ventilator requirement in the remdesivir arm was one factor that decreased the QALY disutility value. In patients who were transferred to intensive care unit (ICU) from the ward, the mean LOS was 17.3 days (SD 13.6), and the mean cost of stay was USD 155.3/day (SD 168.0), while in patients who were admitted to ICU at baseline, the mean LOS was 13.1 days (SD 13.7), and the mean cost of stay was USD 207.9/day (SD 133.6). The mean cost of episode per patient was USD 3461.1 (SD 2259.8) in the remdesivir arm and USD 3538.9 (SD 3296.0) in the SOC arm. Incremental QALYs were estimated at 0.174. Remdesivir treatment was determined to be cost saving vs. SoC.

Conclusions

Remdesivir, which results in shorter LOS and lower rates of intubation requirements in ICU patients than existing therapies, is associated with higher QALYs and lower costs, dominating SoC in patients with SpO₂ < 94% who require oxygen support.

中文翻译：

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需要低流量氧疗的 COVID-19 患者中瑞德西韦治疗的成本效益分析：土耳其付款人的观点

介绍

本研究旨在评估瑞德西韦与土耳其其他现有疗法 (SoC) 相比的成本效益，以治疗因 < 94% 饱和度和低流量氧疗 (LFOT) 要求住院的 COVID-19 患者。

方法

我们将瑞德西韦作为 COVID-19 的治疗方法与土耳其治疗指南中的治疗方法进行了比较。 使用来自在三级医疗机构接受 LFOT 的78 名 SpO ₂ < 94%的住院 COVID-19 患者的数据进行分析。从付款人的角度考虑在同一组中模拟瑞德西韦治疗的成本，计算了 78 名患者的 COVID-19 发作成本。计算了瑞德西韦与所确定人群的 SoC 的每个质量调整生命年 (QALY) 的增量成本效益比 (ICER)。对于土耳其，每 QALY 使用的报销阈值介于 8599 美元（1 × 人均国内生产总值 - GDP）和 25.797 美元（3 × GDP）之间。

结果

在瑞德西韦组中，住院时间 (LOS) 比 SOC 短 3 天。瑞德西韦组的呼吸机需求低是降低 QALY 负效用值的因素之一。从病房转入重症监护病房 (ICU) 的患者，平均住院时间为 17.3 天 (SD 13.6)，平均住院费用为 155.3 美元/天 (SD 168.0)，而入院的患者ICU 基线时，平均 LOS 为 13.1 天 (SD 13.7)，平均住院费用为 207.9 美元/天 (SD 133.6)。瑞德西韦组每名患者的平均发作费用为 3461.1 美元（2259.8 美元），SOC 组为 3538.9 美元（3296.0 美元）。增量 QALY 估计为 0.174。瑞德西韦治疗被确定为比 SoC 节省成本。

结论

与现有疗法相比，瑞德西韦导致 ICU 患者的 LOS 更短，插管需求率更低，与更高的 QALY 和更低的成本相关，在 需要氧气支持的 SpO _{2 < 94% 的患者中占主导地位。}