Evidence map›Paper›PMID 39696409›Full record

ArticleEuropean journal of medical research2024

Impact of oral early antiviral therapies for mild-moderate COVID-19 in the outpatient's setting during Omicron era: a pharmacoeconomic analysis.

Vincenzo Scaglione, Samuele Gardin, Lolita Sasset, Nicolò Presa, Alberto Rossetto, Deris Gianni Boemo, Sofia Silvola, Umberto Restelli, Annamaria Cattelan

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In one paragraph

Article in European journal of medical research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

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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

9 authors.

Vincenzo ScaglioneInfectious and Tropical Diseases Unit, Padua University Hospital, 35128, Padua, Italy. vincenzo.scaglione@aopd.veneto.it.ORCID http://orcid.org/0000-0002-2911-2255
Samuele GardinInfectious and Tropical Diseases Unit, Padua University Hospital, 35128, Padua, Italy.
Lolita SassetInfectious and Tropical Diseases Unit, Padua University Hospital, 35128, Padua, Italy.
Nicolò PresaInfectious and Tropical Diseases Unit, Padua University Hospital, 35128, Padua, Italy.
Alberto RossettoInfectious and Tropical Diseases Unit, Padua University Hospital, 35128, Padua, Italy.
Deris Gianni BoemoDepartment of Directional Hospital Management, Padua University Hospital, Padua, Italy.
Sofia SilvolaLIUC Business School, LIUC University, Castellanza, VA, Italy.
Umberto Restelli *LIUC Business School, LIUC University, Castellanza, VA, Italy.
Annamaria Cattelan *Infectious and Tropical Diseases Unit, Padua University Hospital, 35128, Padua, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMolnupiravir (MOL) and nirmatrelvir/ritonavir (NIR) decreased mortality and hospital admissions in high-risk patients with mild to moderate COVID-19. Nevertheless, there is a lack of data about the pharmacoeconomic impact of these antivirals in the Omicron era. We conducted a pharmacoeconomic analysis assessing the medical costs of the use of these antivirals compared to those occurred in people who refused the treatment.

methodsThe study included the first 50 patients vaccinated against SARS-CoV-2 of each month who experienced mild to moderate COVID-19 and were consecutively treated with oral antivirals at Padua University Hospital between February 1, 2022, and June 30, 2022. In addition, all consecutive patients who met the criteria for antiviral therapy during this period but opted not to receive treatment were included as control group. The two groups were compared in terms of costs associated with emergency department visits and hospitalizations, which were identified as the primary outcomes of the study.

resultsNine-hundred-sixty-one patients were analysed, mean age was 67.72 ± 15.19 years and 49% were males. The most prevalent comorbidities were cardiovascular disease (57%), obesity (18) and diabetes mellitus (18%). Two-hundred-fifty-one (26%) patients were treated with MOL (group A), 252/961 (26%) were treated with NIR (group B) and 458/961 (48%) refused antiviral therapy (group C). While a generally more favourable outcomes was observed in the early treated group, no statistically significance differences between hospitalization or emergency department visits were found between group A and C and between group B and C. Total direct medical costs were statistically significantly higher both comparing group A (671.42 ± 460€) vs. group C and comparing group B (1008.42 ± 1562€) vs. group C (446.58 ± 4977€). The main cost driver associated with the increased cost was the antiviral therapy. The average hospitalization cost was 19,334.3 ± 27,030€ for group C, 8956.2 ± 7412€ for group B and 10,267.2€ for group A.

conclusionsIn the context of the Omicron variant during the COVID-19 pandemic, the use of early oral antiviral agents in vaccinated individuals was found to be more expensive compared to avoid treatment, primarily due to the high costs associated with it. To enhance the efficiency in resource allocation, it is essential to pursue policies aimed at reducing drug costs, along with conducting further pharmaco-economic studies.

Indexed as

Antiviral AgentsCOVID-19COVID-19 Drug TreatmentDrug CombinationsEconomics, PharmaceuticalHydroxylaminesRitonavirSARS-CoV-2Administration, OralAgedAged, 80 and overCytidineFemaleHospitalizationHumansLeucineAntiviral AgentsCytidineDrug CombinationsHydroxylaminesLeucineLopinavirlopinavir-ritonavir drug combinationmolnupiravirRitonavir

Identifiers

PMID39696409
PMCPMC11658409

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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.