Barnieh Lianne, Beckerman Rachel, Jeyakumar Sushanth, Hsiao Alice, Jarrett James, Gottlieb Robert L
Maple Health Group, New York, NY, USA.
Gilead Sciences, Foster City, CA, USA.
Infect Dis Ther. 2023 Jun;12(6):1655-1665. doi: 10.1007/s40121-023-00816-y. Epub 2023 May 24.
In addition to significant morbidity and mortality, the coronavirus disease (COVID-19) has strained health care systems globally. This study investigated the cost-effectiveness of remdesivir + standard of care (SOC) for hospitalized COVID-19 patients in the USA.
This cost-effectiveness analysis considered direct and indirect costs of remdesivir + SOC versus SOC alone among hospitalized COVID-19 patients in the US. Patients entered the model stratified according to their baseline ordinal score. At day 15, patients could transition to another health state, and on day 29, they were assumed to have either died or been discharged. Patients were then followed over a 1-year time horizon, where they could transition to death or be rehospitalized.
Treatment with remdesivir + SOC avoided, per patient, a total of 4 hospitalization days: two general ward days and a day for both the intensive care unit and the intensive care unit plus invasive mechanical ventilation compared to SOC alone. Treatment with remdesivir + SOC presented net cost savings due to lower hospitalization and lost productivity costs compared to SOC alone. In increased and decreased hospital capacity scenarios, remdesivir + SOC resulted in more beds and ventilators being available versus SOC alone.
Remdesivir + SOC alone represents a cost-effective treatment for hospitalized patients with COVID-19. This analysis can aid in future decisions on the allocation of healthcare resources.
除了造成严重的发病率和死亡率外，冠状病毒病（COVID-19）还使全球医疗系统不堪重负。本研究调查了瑞德西韦联合标准治疗（SOC）方案对美国住院COVID-19患者的成本效益。
本成本效益分析考虑了美国住院COVID-19患者中，瑞德西韦联合SOC方案与单纯SOC方案的直接和间接成本。患者根据基线序贯评分分层进入模型。在第15天，患者可转换至另一种健康状态，在第29天，假定患者已死亡或出院。然后对患者进行为期1年的随访，期间患者可能死亡或再次住院。
与单纯SOC方案相比，瑞德西韦联合SOC方案每位患者总共避免了4个住院日：两个普通病房日，以及各1个重症监护病房日和重症监护病房加有创机械通气日。与单纯SOC方案相比，瑞德西韦联合SOC方案因住院费用降低和生产力损失成本降低而实现了净成本节约。在医院容量增加和减少的情况下，与单纯SOC方案相比，瑞德西韦联合SOC方案可提供更多床位和呼吸机。
单独使用瑞德西韦联合SOC方案是治疗住院COVID-19患者的一种具有成本效益的治疗方法。该分析有助于未来医疗资源分配决策。
