Istituto Superiore di Sanità (ISS), Rome, Italy.
St. Camillus International University of Health Sciences, Rome, Italy.
PLoS One. 2023 Feb 10;18(2):e0279022. doi: 10.1371/journal.pone.0279022. eCollection 2023.
In 2020, the world was profoundly affected by the spread of SARS-CoV-2, a novel coronavirus first identified in December 2019, that was the causative agent of coronavirus disease 2019 (Covid-19), a severe respiratory disease classified as a pandemic by the World Health Organization (WHO) in March 2020. Covid-19 had a significant negative impact on the healthcare facilities and the economies of many countries. A need for pharmacological treatments for Covid-19 patients rapidly emerged to limit the damage caused by the disease and allow for more efficient management of hospital resources. A possible alternative treatment that has achieved encouraging results on Covid-19 is the use of monoclonal antibodies. This research aims to evaluate the cost-effectiveness of a type of monoclonal antibody, specifically the combination of casirivimab and imdevimab, and assess its impact on the Italian healthcare system.
The casirivimab and imdevimab treatment efficacy on outpatients with Covid-19 was tested using a predictive Markov model. Research endpoints include hospitalizations, Intensive Care Unit (ICU) admissions, and deaths. This was translated into terms of benefits (savings) and costs for the Italian National Health Service (NHS). The model operates on a predictive time frame of 20 weeks starting from September 2021 until January 2022. The data used to populate the model comes from international academic studies and open-access resources on online databases.
The model estimates the effects that can be achieved by administering casirivimab and imdevimab treatment on outpatients with Covid-19. According to the estimates, the treatment can prevent approximately 4,000 hospitalizations, 3,589 ICU admissions, and 1,500 deaths in the considered 20-week period. The potential cost savings amount to EUR 78 million, mainly attributable to the reduction in the number of hospitalizations and access to ICU. More specifically, a difference of EUR 15,4 million can be observed due to the reduction in the number of hospitalizations, a difference of EUR 59,3 million due to the reduction in the number in intensive care, and a difference of EUR 20,3 million due to the reduction in deaths as a consequence of the reduction of hospitalizations. These results are already very significant, considering that in Italy, only 4.76% of the population is eligible for monoclonal antibody treatment.
The administration of casirivimab and imdevimab in outpatients with Covid-19 can accelerate recovery from the disease for patients, make hospital resource management more efficient and significantly reduce costs for healthcare facilities.
2020 年，世界深受新型冠状病毒（SARS-CoV-2）传播的影响，这种新型冠状病毒于 2019 年 12 月首次被发现，是导致 2019 年冠状病毒病（Covid-19）的病原体，该病被世界卫生组织（WHO）于 2020 年 3 月归类为大流行。Covid-19 对许多国家的医疗设施和经济产生了重大负面影响。为了限制疾病造成的损害并更有效地管理医院资源，迅速出现了针对 Covid-19 患者的药物治疗需求。一种可能的替代治疗方法是使用单克隆抗体，在治疗 Covid-19 方面取得了令人鼓舞的结果。本研究旨在评估一种单克隆抗体（casirivimab 和 imdevimab 的组合）的成本效益，并评估其对意大利医疗保健系统的影响。
使用预测马尔可夫模型测试 casirivimab 和 imdevimab 对门诊 Covid-19 患者的治疗效果。研究终点包括住院、重症监护病房（ICU）入院和死亡。这转化为意大利国家卫生服务（NHS）的收益（节省）和成本。该模型基于 2021 年 9 月至 2022 年 1 月的 20 周预测时间框架运行。用于填充模型的数据来自国际学术研究和在线数据库的开放获取资源。
该模型估计了对门诊 Covid-19 患者使用 casirivimab 和 imdevimab 治疗可实现的效果。根据估计，在考虑的 20 周内，该治疗可预防约 4000 例住院、3589 例 ICU 入院和 1500 例死亡。潜在的节省成本约为 7800 万欧元，主要归因于住院和 ICU 人数的减少。更具体地说，由于住院人数减少，可观察到 1540 万欧元的差异，由于 ICU 人数减少，可观察到 5930 万欧元的差异，由于住院人数减少导致死亡人数减少，可观察到 2030 万欧元的差异。这些结果已经非常显著，因为在意大利，只有 4.76%的人口有资格接受单克隆抗体治疗。
在门诊 Covid-19 患者中使用 casirivimab 和 imdevimab 可以加速患者的康复，提高医院资源管理效率，并显著降低医疗保健机构的成本。
