Department of Pharmacy, Northwest Women's and Children's Hospital, Xi'an, Shaanxi, China.
Department of Pharmacy, Affiliated Hospital of Jining Medical University, Jining, China.
Front Public Health. 2023 Jun 19;11:1174879. doi: 10.3389/fpubh.2023.1174879. eCollection 2023.
To assess the cost-effectiveness of Paxlovid in reducing severe COVID-19 and its associated morality, and to investigate the affordable price of Paxlovid in China.
Using a Markov model, two interventions by Paxlovid prescription (with and without prescription) were compared in terms of COVID-19-related clinical outcomes and economic loss. COVID-related costs were collected from the societal perspective. Effectiveness data were obtained from literature. The primary outcomes were total social cost, disability adjusted life-years (DALYs) and net monetary benefit (NMB). Scenario analyses were performed to investigate the affordable price of Paxlovid in China. Deterministic sensitivity analyses (DSA) and probabilistic sensitivity analysis (PSA) were performed to verify the model robustness.
Compared with the non-Paxlovid cohort, the NMBs of the Paxlovid cohort were only higher in the subgroup of patients aged over 80 years old, regardless of their vaccination status. Our scenario analysis found that, the price ceiling of Paxlovid/box for it to be cost-effective was RMB 8,993 (8,970-9,009) in those aged over 80 years old who were not vaccinated, which is the highest; and was RMB 35 (27-45) in those aged 40-59 years old who were vaccinated, which is the lowest. Sensitivity analyses found that the incremental NMB for the vaccinated people aged over 80 years was most sensitive to the efficacy of Paxlovid and the cost-effectiveness probability of Paxlovid increased with its decreasing price.
Under the current marketing price of Paxlovid/box (RMB 1,890), using Paxlovid was only cost-effective in people aged over 80 years old regardless of their vaccination status.
评估帕罗韦德降低 COVID-19 重症和相关死亡率的成本效益，并探讨帕罗韦德在中国的可负担价格。
采用马尔可夫模型，比较了帕罗韦德处方（有处方和无处方）两种干预措施在 COVID-19 相关临床结局和经济损失方面的效果。从社会角度收集 COVID 相关成本。有效性数据来自文献。主要结果是总社会成本、残疾调整生命年（DALYs）和净货币效益（NMB）。进行情景分析以探讨帕罗韦德在中国的可负担价格。进行确定性敏感性分析（DSA）和概率敏感性分析（PSA）以验证模型的稳健性。
与非帕罗韦德组相比，无论疫苗接种状况如何，在 80 岁以上患者亚组中，帕罗韦德组的 NMB 仅更高。我们的情景分析发现，对于未接种疫苗的 80 岁以上人群，帕罗韦德/盒的价格上限为 8993 元人民币（8970-9009 元），这是最高的；对于接种疫苗的 40-59 岁人群，价格上限为 35 元人民币（27-45 元），这是最低的。敏感性分析发现，对于接种疫苗的 80 岁以上人群，增量 NMB 对帕罗韦德疗效最敏感，随着帕罗韦德价格的降低，其成本效益概率增加。
在帕罗韦德/盒目前的市场价格（1890 元人民币）下，无论疫苗接种状况如何，使用帕罗韦德仅在 80 岁以上人群中具有成本效益。
