Kilcoyne Adrian, Jordan Edward, Thomas Kimberly, Pepper Alicia N, Zhou Allen, Chappell Dale, Amarapala Miyuru, Thériault Rachel-Karson, Thompson Melissa
HEOR, Humanigen Inc, Burlingame, CA, USA.
Value & Evidence Services, EVERSANA, Burlington, Ontario, Canada.
Clinicoecon Outcomes Res. 2022 Apr 14;14:231-247. doi: 10.2147/CEOR.S360741. eCollection 2022.
To estimate the clinical and economic benefits of lenzilumab plus standard of care (SOC) compared with SOC alone in the treatment of hospitalized COVID-19 patients from the National Health Service (NHS) England perspective.
A cost calculator was developed to estimate the clinical benefits and costs of adding lenzilumab to SOC in newly hospitalized COVID-19 patients over 28 days. The LIVE-AIR trial results informed the clinical inputs: failure to achieve survival without ventilation (SWOV), mortality, time to recovery, intensive care unit (ICU) admission, and invasive mechanical ventilation (IMV) use. Base case costs included drug acquisition and administration for lenzilumab and remdesivir and hospital resource costs based on the level of care required. Clinical and economic benefits per weekly cohort of newly hospitalized patients were also estimated.
In all populations examined, specified clinical outcomes were improved with lenzilumab plus SOC over SOC treatment alone. In a base case population aged <85 years with C-reactive protein (CRP) <150 mg/L, with or without remdesivir, adding lenzilumab to SOC was estimated to result in per-patient cost savings of £1162. In a weekly cohort of 4754 newly hospitalized patients, addition of lenzilumab to SOC could result in 599 IMV uses avoided, 352 additional lives saved, and over £5.5 million in cost savings. Scenario results for per-patient cost savings included: 1) aged <85 years, CRP <150 mg/L, and receiving remdesivir (£3127); 2) Black patients with CRP <150 mg/L (£9977); and 3) Black patients from the full population (£2369). Conversely, in the full mITT population, results estimated additional cost of £4005 per patient.
Findings support clinical benefits for SWOV, mortality, time to recovery, time in ICU, time on IMV, and ventilator use, and an economic benefit from the NHS England perspective when adding lenzilumab to SOC for hospitalized COVID-19 patients.
从英国国家医疗服务体系（NHS）的角度，评估与单独使用标准治疗（SOC）相比，在治疗住院的新冠肺炎患者时，联合使用lenzilumab与SOC的临床和经济效益。
开发了一个成本计算器，以估计在28天内，将lenzilumab添加到新入院的新冠肺炎患者的SOC治疗中的临床益处和成本。LIVE-AIR试验结果为临床输入提供了依据：无创生存失败（SWOV）、死亡率、恢复时间、重症监护病房（ICU）入院率和有创机械通气（IMV）使用率。基础成本包括lenzilumab和瑞德西韦的药物采购及给药成本，以及基于所需护理水平的医院资源成本。还估计了每周新入院患者队列的临床和经济效益。
在所有研究人群中，与单独使用SOC治疗相比，联合使用lenzilumab与SOC可改善特定的临床结局。在基础病例人群中，年龄<85岁、C反应蛋白（CRP）<150mg/L，无论是否使用瑞德西韦，将lenzilumab添加到SOC中估计可使每位患者节省成本1162英镑。在每周4754名新入院患者的队列中，将lenzilumab添加到SOC中可避免599次IMV使用，挽救352条生命，并节省超过550万英镑的成本。每位患者节省成本的情景分析结果包括：1）年龄<85岁、CRP<150mg/L且接受瑞德西韦治疗（3127英镑）；2）CRP<150mg/L的黑人患者（9977英镑）；3）全体人群中的黑人患者（2369英镑）。相反，在完整的意向性分析（mITT）人群中，结果估计每位患者额外成本为4005英镑。
研究结果支持联合使用lenzilumab与SOC对SWOV、死亡率、恢复时间、ICU住院时间、IMV使用时间和呼吸机使用的临床益处，以及从NHS的角度来看，在住院的新冠肺炎患者中添加lenzilumab到SOC的经济效益。
