Cost-effectiveness analysis of nirmatrelvir/ritonavir in adult patients at high risk of progressing to severe COVID-19
Objective: This study aimed to estimate the cost-effectiveness of nirmatrelvir/ritonavir (NMV/r) versus the standard of care (SoC) for patients with mild-to-moderate coronavirus disease 2019 (COVID-19) at high risk for progression to severe illness from the perspective of the Italian National Healt...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
AboutScience Srl
2025-07-01
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| Series: | Global & Regional Health Technology Assessment |
| Subjects: | |
| Online Access: | https://journals.aboutscience.eu/index.php/grhta/article/view/3403 |
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| Summary: | Objective: This study aimed to estimate the cost-effectiveness of nirmatrelvir/ritonavir (NMV/r) versus the standard of care (SoC) for patients with mild-to-moderate coronavirus disease 2019 (COVID-19) at high risk for progression to severe illness from the perspective of the Italian National Health Service.
Methods: A cost-effectiveness model was developed using a closed cohort of 1,000 infected patients. It employed
a short-term decision tree (1 year) followed by a lifetime 2-state Markov model (alive and dead). The
short-term decision tree captured costs and outcomes associated with the primary infection and healthcare utilization; survivors of the short-term decision tree were followed until death to calculate Italian quality-adjusted
life years (QALYs), adjusted in the short-term for survivors to mechanical ventilation. Baseline hospitalization rate
and NMV/r effectiveness were sourced from the Istituto Superiore di Sanità (ISS) and the randomized clinical trial
Evaluation of Protease Inhibition for COVID-19 in High-Risk Patients (EPIC-HR), respectively. Other inputs were
given by previous COVID-19 studies and publicly available sources. Sensitivity analyses were conducted for all
model inputs to test the robustness of the results of the model.
Results: NMV/r presented an advantageous cost-effectiveness ratio of 2,237 €/QALY, compared to the SoC, in the
long-term horizon (30 years). Results were most sensitive to baseline risk of hospitalization and NMV/r treatment
effectiveness parameters. The probabilistic analysis indicated that NMV/r has a 100% probability of being costeffective at a 33,004 € willingness-to-pay threshold.
Conclusions: From the Italian National Health Service perspective, NMV/r is cost-effective compared to the standard of care for patients at high risk for severe COVID-19.
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| ISSN: | 2284-2403 2283-5733 |