Evidence map›Paper›PMID 38058141›Full record

ArticleJournal of managed care & specialty pharmacy2023

Budget impact of oral nirmatrelvir/ritonavir in adults at high risk for progression to severe COVID-19 in the United States.

Rickard Sandin, David L Veenstra, Mathilde Vankelegom, Mendwas Dzingina, Sean D Sullivan, David Campbell, Cuiying Ma, Cale Harrison, Florin Draica, Timothy Lee Wiemken and 1 more

Open access · greenAbstract read
In one paragraph

Article in Journal of managed care & specialty pharmacy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.4field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 7 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 2 countries.

Rickard SandinPfizer AB, Stockholm, Sweden.
David L VeenstraUniversity of Washington, Seattle.
Mathilde VankelegomHealth Economics & Outcomes Research Ltd, Cardiff, Wales, UK.
Mendwas DzinginaPfizer R&D, Tadworth UK.
Sean D SullivanUniversity of Washington, Seattle.
David CampbellCurta, Inc., Seattle, WA.
Cuiying MaHealth Economics & Outcomes Research Ltd, Cardiff, Wales, UK.
Cale HarrisonHealth Economics & Outcomes Research Ltd, Cardiff, Wales, UK.
Florin DraicaPfizer Inc, New York City, NY.
Timothy Lee WiemkenPfizer Inc, New York City, NY.
Tendai MugwagwaPfizer R&D, Tadworth UK.
Behavioral Tech Research, Inc. · USPfizer (United States) · USPfizer (Sweden) · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNirmatrelvir/ritonavir (NMV/r) is indicated for the treatment of mild-to-moderate COVID-19 in adults who are at high risk for progression to severe COVID-19. NMV/r has also been authorized for emergency use by the US Food and Drug Administration for the treatment of mild-to-moderate COVID-19 in pediatric patients (aged 226512 years and weighing at least 40 kg) who are at high risk for progression to severe COVID-19. Understanding the budget impact of introducing NMV/r for the treatment of adults with COVID-19 is of key interest to US payers.

objectiveTo estimate the annual budget impact of introducing NMV/r in a US commercial health plan setting in the current Omicron COVID-19 era.

methodsA budget impact model was developed to assess the impact of NMV/r on health care costs in a hypothetical 1-million-member commercial health insurance plan over a 1-year period in the US population; clinical and cost inputs were derived from published literature with a focus on studies in the recent COVID-19 era that included vaccinated population and predominance of the Omicron variant. In the base-case analysis, it was assumed the only effect of NMV/r was a reduction in incidence (not severity) of hospitalization or death; its potential effect on post-COVID conditions was assessed in a scenario analysis. Outcomes included the number of hospitalizations, total cost, per patient per year (PPPY) costs, and per member per month (PMPM) costs. Sensitivity and scenario analyses were conducted to assess uncertainty around key model inputs.

resultsAn estimated 29,999 adults were eligible and sought treatment with oral antiviral for COVID-19 over 1 year. The availability of NMV/r was estimated to reduce the number of hospitalizations by 647 with a total budget impact of $2,733,745, $91 PPPY, and $0.23 PMPM. NMV/r was cost saving when including post-COVID conditions with a -$1,510,780 total budget impact, a PPPY cost of -$50, and a PMPM cost of -$0.13. Sensitivity analyses indicated results were most sensitive to the risk of hospitalization under supportive care, risk of hospitalization with NMV/r treatment and cost of NMV/r.

conclusionsTreatment with NMV/r in the current COVID-19 era is estimated to result in substantial cost offsets because of reductions in hospitalization and modest budget impact to potential overall cost savings.

Indexed as

COVID-19RitonavirAdultBudgetsChildCOVID-19 Drug TreatmentHumansLactamsLeucineNitrilesProlineSARS-CoV-2United StatesLactamsLeucinenirmatrelvirNitrilesProlineRitonavir

Identifiers

PMID38058141
PMCPMC10776264
OpenAlexW4389432822

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.