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Table 3 Main cost-effectiveness results

From: Cost-effectiveness of remdesivir for the treatment of hospitalized patients with COVID-19: a systematic review

Reference (year of publication)

Intervention

Total Costs (USD 2020)

Mean QALY/ QALD/ Disutility / Death averted/ evLYG

Cost-effectiveness measure(USD 2020)

Cost-effective against the standard of care?

QALY

LYG

QALD

Disutility

Death averted

evLYG

Whittington (2022)

Moderate to severe population

SoC + Remdesivir

313,447

12.189

–

–

–

–

–

Incremental Cost per QALY: USD 298, 200

Value-based price : 4000–13,500

No

SoC

311,617

12.182

–

–

–

–

–

Ref.

Mild population

SoC + Remdesivir

318,375

13.702

–

–

–

–

–

Incremental Cost per QALY: 1,847, 000

Value-based price : 700-4,600

SoC

315,629

13.701

–

–

–

–

–

Ref.

Rafia (2022)

SoC

12,958.40

6.35

–

–

–

–

–

Ref.

It is cost-effective if remdesivir prevents death

Remdesivir

17,558.59

6.63

–

–

–

–

–

Incremental Cost per QALY: 16,403.02

Kelto (2022)

Payer perspective

All patient

Baricitinib-Remdesivir

380,396

12.0641

15.0641

–

–

–

–

Incremental Cost per QALY: 22,334

Incremental Cost per LYG:17,858

Baricitinib-Remdesivir is cost-effective compared to using REM for hospitalized patients with COVID-19.

Remdesivir

372,434

11.7076

14.754

–

–

–

–

Ref.

Patient with oxygen use

Baricitinib-Remdesivir

379,487

11.9480

15.056

–

–

–

–

Incremental Cost per QALY: 21,818

Incremental Cost per LYG:17,458

Remdesivir

370,527

11.5373

14.543

–

–

–

–

Ref.

Hospital perspective

All patient

Baricitinib-Remdesivir

Incremental total expenditure : − 1778

Incremental total QALYs: 0.0018

–

–

–

–

–

Dominates

Remdesivir

–

–

–

–

–

Ref.

Patient with oxygen use

Baricitinib-Remdesivir

Incremental total expenditure : − 2709

Incremental total QALYs: 0.0023

–

–

–

–

–

Dominates

Remdesivir

–

–

–

–

–

Ref.

Dijk (2022)

Casirivimab-Imdevimab

Incremental cost : 696

Incremental QALY : 0.171

–

–

–

–

–

Incremental Cost per QALY: 4075

ICER< WTP

Yes

Remdesivir

Incremental cost : − 5

Incremental QALY : 0.252

–

–

–

–

–

Dominates

Dexamethasone

Incremental cost :6856

Incremental QALY : 0.614

–

–

–

–

–

Incremental Cost per QALY: 111,699

ICER< WTP

Baricitinib-Remdesivir

Incremental cost : 10,673

Incremental QALY : 0.775

–

–

–

–

–

Incremental Cost per QALY: 13,772

ICER< WTP

Tocilizumab

Incremental cost : 35,849

Incremental QALY : 0.882

–

–

–

–

–

Incremental Cost per QALY: 40,633

ICER< WTP

Interferon beta-1a

Incremental cost : − 2538

Incremental QALY :− 0.472

–

–

–

–

–

Incremental Cost per QALY: 5377

Cost-saving

Lopinavir-ritonavir

Incremental cost : − 1404

Incremental QALY : − 0.091

–

–

–

–

–

Incremental Cost per QALY:15418

Cost-saving

Hydroxychloroquine

Incremental cost : − 12,227

Incremental QALY :− 0.263

–

–

–

–

–

Incremental Cost per QALY:46427

Cost-saving

Jo (2021)

SoC

83,937

–

–

–

–

Ref.

–

Ref

Remdesivir for non-ventilated patients & dexamethasone for ventilated patients

69,346

–

–

–

–

408

–

Incremental Cost per death averted: Cost-saving

Yes,

the use of remdesivir for nonventilated patients and dexamethasone for ventilated patients is likely to be cost-saving.

Dexamethasone for non-ventilated & ventilated patients

84,096

–

–

–

–

689

–

Incremental Cost per death averted: USD 231

Remdesivir for non-ventilated patients (58%) only

69,279

–

–

–

–

26

–

Incremental Cost per death averted: Cost-saving

Dexamethasone for ventilated patients (42%) only

84,003

–

–

–

–

382

–

Incremental Cost per death averted: USD174

Jiang (2021)

SoC

641,356,115.72

–

–

512,651,191

–

–

–

Ref

Yes

Remdesivir

669,201,230.38

–

–

512,677,159

–

–

–

ICER: USD 4,008.53

Okuz (2021)

SoC

3538.9

–

–

–

0.515

–

–

INB: USD 1575.6 (1*GDP)

INB: USD 4,571.4 (3*GDP)

Yes

Remdesivir

3461.1

–

–

–

0.341

–

–

Ohsfeldt (2021)

Payer perspective

Placebo + SoC(systemic corticosteroids and Remdesivir)

329,268

11.3879

14.300

–

–

–

–

Ref.

Addition of baricitinib to SOC (systemic corticosteroids and Remdesivir) was cost-effective.

Baricitinib + SoC

346,544

12.0582

15.137

–

–

–

–

Incremental Cost per QALY: USD 25,774

Incremental Cost per LYG: USD 20,638

Hospital perspective

Placebo + SoC(systemic corticosteroids and Remdesivir)

Incremental total expenditure: − 2436

Incremental total QALYs: 0.0023

–

–

–

–

–

Ref.

Baricitinib + SoC

–

–

–

–

–

Dominates

Congly (2021)

Supportive care

11,112.98

0.7155

–

–

–

–

–

–

No

Dexamethasone severe

11,115.86

0.7256

–

–

–

–

–

–

Dexamethasone all

11,132.18

0.7351

–

–

–

–

–

–

Remdesivir severe

11,756.48

0.7100

–

–

–

–

–

–

Remdesivir moderate

13,101.98

0.7245

–

–

–

–

–

–

Remdesivir moderate, dexamethasone severe

13,104.86

0.7346

–

–

–

–

–

–

Remdesivir all

13,745.48

0.7190

–

–

–

–

–

–

Carta (2021)

SoC

33,369.9

0.7673

–

–

–

–

–

–

Yes

dexamethasone

33,555.6

0.803

–

–

–

–

–

–

Remdesivir

32,354.4

0.7734

–

–

–

–

–

Dominant

Remdesivir+ dexamethasone

32,540.2

0.809

–

–

–

–

–

Dominant

Wu (2021)

SoC

31,159

0.04376

–

–

–

–

–

ICER: USD 32,809,252

No

SoC + Remdesivir

36,990

0.04554

–

–

–

–

–

Whittington (2020)

SoC

305,230

12.18

–

–

–

–

12.19

Ref

This study aimed to provide pricing estimates for remdesivir for the treatment of COVID-19.

SoC + Remdesivir

319,230

12.46

–

–

–

–

12.48

WTP = USD50,000 per QALY and per evLYG Cost-effectiveness price benchmark: USD 4580–USD 5080

WTP = USD100,000 per QALY and per evLYG,

Cost-effectiveness price benchmark: USD 18,640 - USD 19,630

WTP = USD 150,000 per QALY and per evLYG, Cost-effectiveness price benchmark: USD 32,700–USD 34,180

  1. SoC Standard of care, QALY Quality adjusted life-years, evLYG Equal value of life years gained, QALD Quality adjusted life-days, LYG Life years gained, WTP Willingness-to-pay, –: Not applicable