Stremel Timotheus, Schnaidt Svitlana, Bihrer Nicole, Fröling Emma, Jacob Christian, Kisser Agnes
Xcenda GmbH, Part of Cencora Inc., Lange Laube 31, 30159, Hannover, Germany.
Pfizer Pharma GmbH, Berlin, Germany.
Infect Dis Ther. 2025 Jan;14(1):149-165. doi: 10.1007/s40121-024-01088-w. Epub 2024 Dec 8.
Individuals at increased risk of severe coronavirus disease 2019 (COVID-19) progression have a higher probability of being hospitalized. Nirmatrelvir/ritonavir (NMV/r) is an antiviral drug aiming to prevent severe disease courses. Our study aimed to assess the resource utilization and costs of adults hospitalized for COVID-19 at high risk for severe disease progression.
A retrospective study was conducted using German claims data. The presence of high-risk criteria was determined through recorded diagnoses, operations, procedures, and prescriptions. Individuals at high risk for severe COVID-19 progression, primarily hospitalized for COVID-19, required a recorded diagnosis for COVID-19 and additionally a diagnosis of sepsis, pulmonary embolism, acute respiratory failure, pneumonia, or a remdesivir prescription. Patients were grouped by eligibility for NMV/r treatment (eligible, eligible with restrictions, and not eligible). The outcomes of interest were reported for the timeframe of the last dominant virus variant available in the database, i.e., Delta (June 21, 2021 to December 31, 2021).
Of approximately 3.7 million individuals continuously observable in the database, about 60% were identified as being at high risk for severe COVID-19 progression. Among high-risk individuals, 2938 patients were primarily hospitalized for COVID-19 between June 21, 2021, and December 31, 2021, two-thirds of which were suitable for NMV/r treatment (half without restrictions). Advanced age (86.3%) and cardiovascular conditions (83.9%) were the most prevalent of the predefined risk factors. Identified patients stayed, on average, 11.3 days in hospital, with inpatient mortality of 18.9%. These COVID-19-related hospitalizations resulted in mean healthcare costs of €8728.
This study reflects the economic burden of hospitalized adult individuals with COVID-19 at high risk for severe disease progression from payer's perspective in Germany. Our findings highlight the need to prevent severe disease courses and associated hospitalizations to relieve healthcare systems regarding costs and resource allocation.
2019年冠状病毒病（COVID-19）病情严重进展风险增加的个体住院概率更高。奈玛特韦/利托那韦（NMV/r）是一种旨在预防病情严重发展的抗病毒药物。我们的研究旨在评估因COVID-19住院且病情严重进展风险高的成年人的资源利用情况和成本。
利用德国理赔数据进行回顾性研究。通过记录的诊断、手术、操作和处方确定高风险标准的存在。COVID-19病情严重进展风险高且主要因COVID-19住院的个体，需要有COVID-19的记录诊断，另外还需要有败血症、肺栓塞、急性呼吸衰竭、肺炎的诊断或瑞德西韦处方。患者按NMV/r治疗资格分组（合格、有条件合格和不合格）。在数据库中可获得的最后一个主要病毒变体（即德尔塔，2021年6月21日至2021年12月31日）的时间范围内报告了感兴趣的结果。
在数据库中持续观察的约370万人中，约60%被确定为COVID-19病情严重进展风险高。在高风险个体中，2938例患者在2021年6月21日至2021年12月31日期间主要因COVID-19住院，其中三分之二适合NMV/r治疗（一半无限制）。高龄（86.3%）和心血管疾病（83.9%）是预定义风险因素中最常见的。确诊患者平均住院11.3天，住院死亡率为18.9%。这些与COVID-19相关的住院导致平均医疗费用为8728欧元。
本研究从德国支付方的角度反映了因COVID-19住院且病情严重进展风险高的成年个体的经济负担。我们的研究结果强调需要预防病情严重发展及相关住院，以减轻医疗系统在成本和资源分配方面的负担。
