ArticleThe Lancet regional health. Western Pacific2023
Association of Molnupiravir and Nirmatrelvir-Ritonavir with preventable mortality, hospital admissions and related avoidable healthcare system cost among high-risk patients with mild to moderate COVID-19.
Article in The Lancet regional health. Western Pacific, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 62 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
62 citing papers in PubMed, 7 syntheses or guidelines pooled it, 116 citations in OpenAlex.
- Effectiveness of Nirmatrelvir/Ritonavir for Outpatients in the Era of Omicron, Vaccination, and Previous Infection: A Meta-analysis.Journal of general internal medicine · 2026Pooled it
- Pooled it
- Comparative Effectiveness of Antivirals and Monoclonal Antibodies for Treating COVID-19 Patients Infected With Omicron Variant: A Systematic Review and Network Meta-Analysis.Influenza and other respiratory viruses · 2024Pooled it
- Efficacy and safety of nirmatrelvir/ritonavir (Paxlovid) for COVID-19: A rapid review and meta-analysis.Journal of medical virology · 2023Pooled it
- Pooled it
- Diagnostics and treatments of COVID-19: two-year update to a living systematic review of economic evaluations.Frontiers in pharmacology · 2023Pooled it
- Nirmatrelvir/Ritonavir Regimen for Mild/Moderately Severe COVID-19: A Rapid Review With Meta-Analysis and Trial Sequential Analysis.Annals of family medicinePooled it
- Real Clinical Effectiveness of Molnupiravir Against 30-day Mortality Among 74 541 SARS-CoV-2-Positive Patients: A Nationwide Cohort Study From the Czech Republic.Open forum infectious diseases · 2024Trial
- Nebulized inhalation of plasma-activated water in the treatment of progressive moderate COVID-19 patients with antiviral treatment failure: a randomized controlled pilot trial.BMC infectious diseases · 2024Trial
- Effectiveness of Molnupiravir and Nirmatrelvir-Ritonavir in Hospitalized Patients With COVID-19 : A Target Trial Emulation Study.Annals of internal medicine · 2023Trial
- Effectiveness of the Approved Nirmatrelvir/Ritonavir and Molnupiravir Regimens for Treatment of Mild/Moderate Laboratory-Confirmed SARS-CoV-2 Infection in Patients Aged 18-64 Years in Hong Kong: A Population-Based Cohort Study.Clinical drug investigation · 2026Article
- Economic Evaluation of Oral Nirmatrelvir-Ritonavir for COVID-19 in Higher Risk Outpatients.JAMA network open · 2026Article
- Pharmacokinetics and Safety of Single and Multiple Doses of Molnupiravir in Healthy Male Chinese Adults: An Open-Label, Fixed Sequence, Phase 1 Study.Clinical and translational science · 2026Article
- Evaluating the effectiveness and safety of Azvudine for hospitalised patients with COVID-19 and hypertension: a multicenter retrospective cohort study.Scientific reports · 2026Article
- Safety and Efficacy of Concomitant Nirmatrelvir/Ritonavir and Direct Oral Anticoagulant Therapies for COVID-19 Among Patients With Atrial Fibrillation.Journal of the American Heart Association · 2026Article
- Nirmatrelvir/Ritonavir Efficacy in Immunocompetent Patients with Confirmed Omicron Variant of Severe Acute Respiratory Syndrome Coronavirus 2: An Updated Systematic Review and Meta-analysis.Journal of research in pharmacy practice · 2026Review
- Budget Impact of Adopting Nirmatrelvir-Ritonavir for Treating COVID-19 in a Large Integrated Healthcare System.Open forum infectious diseases · 2025Article
- Effectiveness of Antivirals Nirmatrelvir-Ritonavir and Molnupiravir in Viral Sepsis: Retrospective Cohort Study.JMIR public health and surveillance · 2025Article
- Cost-Effectiveness Analysis of Molnupiravir Versus Best Supportive Care for the Treatment of Outpatient COVID-19 in High-Risk Older Adults in Japan.PharmacoEconomics - open · 2025Article
- Impact of early and delayed azvudine administration on COVID-19 mortality: a retrospective study.Scientific reports · 2025Article
2 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Real-world data is currently limited on the association between oral antiviral therapy and healthcare system burden in patients with mild-to-moderate COVID-19. This study aims to evaluate the clinical and cost effectiveness of Molnupiravir and Nirmatrelvir-ritonavir use in reducing mortality in this population. Methods: This is a retrospective cohort study involving 54,355 COVID-19 patients during February 22-March 31,2022 in Hong Kong. Inverse probability of treatment weighting (IPTW) was used to adjust patient characteristics. Our exposure of interest was Molnupiravir/Nirmatrelvir-Ritonavir prescription, with all-cause mortality as the primary outcome. IPTW-adjusted multivariate regressions were used to estimate treatment impact on clinic re-attendance and unplanned admissions. Finally, attributed cost and incremental cost-effectiveness ratios (ICER) were estimated. Findings: In the outpatient cohort ( Interpretation: In high-risk patients in Hong Kong with mild-to-moderate COVID-19, Molnupiravir and Nirmatrelvir-Ritonavir prescriptions were associated with reduced all-cause mortality and significant cost savings. Funding: Centre for Health Systems & Policy Research is funded by The Tung's Foundation; and The Laboratory of Data Discovery for Health Limited(D24H) is funded the AIR@InnoHK platform administered by the Innovation and Technology Commission of Hong Kong. Funders did not have any role in study design, data collection, data analysis, interpretation and writing of this manuscript.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.