Cost-utility analysis of molnupiravir plus usual care versus usual care alone as early treatment for community-based adults with COVID-19 and increased risk of adverse outcomes in the UK PANORAMIC trial
<p><strong>Background </p></strong>The cost-effectiveness of molnupiravir, an oral antiviral for early treatment of SARS-CoV-2, has not been established in vaccinated populations. <p><strong> Aim </p></strong>To evaluate the cost-effectiveness of molnu...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Royal College of General Practitioners
2024
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| _version_ | 1811140185981714432 |
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| author | Png, ME Harris, V Grabey, J Hart, ND Jani, BD Butler, D Carson-Stevens, A Coates, M Cureton, L Dobson, M Dorward, J Evans, P Francis, N Gbinigie, OA Hayward, G Holmes, J Hood, K Khoo, S Ahmed, H Lown, M McKenna, M Mort, S Nguyen-Van-Tam, J Rahman, N Richards, DB Thomas, N van Hecke, O Hobbs, FR Little, P Yu, L-M Butler, CC Petrou, S |
| author2 | PANORAMIC Trial Collaborators |
| author_facet | PANORAMIC Trial Collaborators Png, ME Harris, V Grabey, J Hart, ND Jani, BD Butler, D Carson-Stevens, A Coates, M Cureton, L Dobson, M Dorward, J Evans, P Francis, N Gbinigie, OA Hayward, G Holmes, J Hood, K Khoo, S Ahmed, H Lown, M McKenna, M Mort, S Nguyen-Van-Tam, J Rahman, N Richards, DB Thomas, N van Hecke, O Hobbs, FR Little, P Yu, L-M Butler, CC Petrou, S |
| author_sort | Png, ME |
| collection | OXFORD |
| description | <p><strong>Background </p></strong>The cost-effectiveness of molnupiravir, an oral antiviral for early treatment of SARS-CoV-2, has not been established in vaccinated populations.
<p><strong>
Aim </p></strong>To evaluate the cost-effectiveness of molnupiravir relative to usual care alone among mainly vaccinated community-based people at higher risk of severe outcomes from COVID-19 over 6 months.
<p><strong>
Design and setting </p></strong>An economic evaluation of the PANORAMIC trial in the UK.
<p><strong>
Method </p></strong>A cost-utility analysis that adopted a UK NHS and personal social services perspective and a 6-month time horizon was performed using PANORAMIC trial data. Cost-effectiveness was expressed in terms of incremental cost per quality-adjusted life year (QALY) gained. Sensitivity and subgroup analyses assessed the impacts of uncertainty and heterogeneity. Threshold analysis explored the price for molnupiravir consistent with likely reimbursement.
<p><strong>
Results </p></strong>In the base-case analysis, molnupiravir had higher mean costs of £449 (95% confidence interval [CI] = 445 to 453) and higher mean QALYs of 0.0055 (95% CI = 0.0044 to 0.0067) than usual care (mean incremental cost per QALY of £81 190). Sensitivity and subgroup analyses showed similar results, except for those aged ≥75 years, with a 55% probability of being cost-effective at a £30 000 per QALY threshold. Molnupiravir would have to be priced around £147 per course to be cost-effective at a £15 000 per QALY threshold.
<p><strong>
Conclusion </p></strong>At the current cost of £513 per course, molnupiravir is unlikely to be cost-effective relative to usual care over a 6-month time horizon among mainly vaccinated patients with COVID-19 at increased risk of adverse outcomes, except those aged ≥75 years. |
| first_indexed | 2024-03-07T08:19:20Z |
| format | Journal article |
| id | oxford-uuid:dfd39c7e-6c3b-4fde-8af6-aa817dc94e61 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-09-25T04:17:58Z |
| publishDate | 2024 |
| publisher | Royal College of General Practitioners |
| record_format | dspace |
| spelling | oxford-uuid:dfd39c7e-6c3b-4fde-8af6-aa817dc94e612024-07-22T14:21:49ZCost-utility analysis of molnupiravir plus usual care versus usual care alone as early treatment for community-based adults with COVID-19 and increased risk of adverse outcomes in the UK PANORAMIC trialJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:dfd39c7e-6c3b-4fde-8af6-aa817dc94e61EnglishSymplectic ElementsRoyal College of General Practitioners2024Png, MEHarris, VGrabey, JHart, NDJani, BDButler, DCarson-Stevens, ACoates, MCureton, LDobson, MDorward, JEvans, PFrancis, NGbinigie, OAHayward, GHolmes, JHood, KKhoo, SAhmed, HLown, MMcKenna, MMort, SNguyen-Van-Tam, JRahman, NRichards, DBThomas, Nvan Hecke, OHobbs, FRLittle, PYu, L-MButler, CCPetrou, S PANORAMIC Trial Collaborators<p><strong>Background </p></strong>The cost-effectiveness of molnupiravir, an oral antiviral for early treatment of SARS-CoV-2, has not been established in vaccinated populations. <p><strong> Aim </p></strong>To evaluate the cost-effectiveness of molnupiravir relative to usual care alone among mainly vaccinated community-based people at higher risk of severe outcomes from COVID-19 over 6 months. <p><strong> Design and setting </p></strong>An economic evaluation of the PANORAMIC trial in the UK. <p><strong> Method </p></strong>A cost-utility analysis that adopted a UK NHS and personal social services perspective and a 6-month time horizon was performed using PANORAMIC trial data. Cost-effectiveness was expressed in terms of incremental cost per quality-adjusted life year (QALY) gained. Sensitivity and subgroup analyses assessed the impacts of uncertainty and heterogeneity. Threshold analysis explored the price for molnupiravir consistent with likely reimbursement. <p><strong> Results </p></strong>In the base-case analysis, molnupiravir had higher mean costs of £449 (95% confidence interval [CI] = 445 to 453) and higher mean QALYs of 0.0055 (95% CI = 0.0044 to 0.0067) than usual care (mean incremental cost per QALY of £81 190). Sensitivity and subgroup analyses showed similar results, except for those aged ≥75 years, with a 55% probability of being cost-effective at a £30 000 per QALY threshold. Molnupiravir would have to be priced around £147 per course to be cost-effective at a £15 000 per QALY threshold. <p><strong> Conclusion </p></strong>At the current cost of £513 per course, molnupiravir is unlikely to be cost-effective relative to usual care over a 6-month time horizon among mainly vaccinated patients with COVID-19 at increased risk of adverse outcomes, except those aged ≥75 years. |
| spellingShingle | Png, ME Harris, V Grabey, J Hart, ND Jani, BD Butler, D Carson-Stevens, A Coates, M Cureton, L Dobson, M Dorward, J Evans, P Francis, N Gbinigie, OA Hayward, G Holmes, J Hood, K Khoo, S Ahmed, H Lown, M McKenna, M Mort, S Nguyen-Van-Tam, J Rahman, N Richards, DB Thomas, N van Hecke, O Hobbs, FR Little, P Yu, L-M Butler, CC Petrou, S Cost-utility analysis of molnupiravir plus usual care versus usual care alone as early treatment for community-based adults with COVID-19 and increased risk of adverse outcomes in the UK PANORAMIC trial |
| title | Cost-utility analysis of molnupiravir plus usual care versus usual care alone as early treatment for community-based adults with COVID-19 and increased risk of adverse outcomes in the UK PANORAMIC trial |
| title_full | Cost-utility analysis of molnupiravir plus usual care versus usual care alone as early treatment for community-based adults with COVID-19 and increased risk of adverse outcomes in the UK PANORAMIC trial |
| title_fullStr | Cost-utility analysis of molnupiravir plus usual care versus usual care alone as early treatment for community-based adults with COVID-19 and increased risk of adverse outcomes in the UK PANORAMIC trial |
| title_full_unstemmed | Cost-utility analysis of molnupiravir plus usual care versus usual care alone as early treatment for community-based adults with COVID-19 and increased risk of adverse outcomes in the UK PANORAMIC trial |
| title_short | Cost-utility analysis of molnupiravir plus usual care versus usual care alone as early treatment for community-based adults with COVID-19 and increased risk of adverse outcomes in the UK PANORAMIC trial |
| title_sort | cost utility analysis of molnupiravir plus usual care versus usual care alone as early treatment for community based adults with covid 19 and increased risk of adverse outcomes in the uk panoramic trial |
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