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 Journal Articles uri icon

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abstract

  • Background: The cost-effectiveness of molnupiravir, an oral antiviral for early treatment of SARS-CoV-2, has not been established in vaccinated populations. Aim: 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 six months. Design and setting: Economic evaluation of the PANORAMIC trial in the UK. Method: A cost-utility analysis that adopted a UK National Health Service and personal social services perspective and a six-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. Results: 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 0.004 to 0.007) than usual care (mean incremental cost per QALY of £81190). Sensitivity and subgroup analyses showed similar results, except those aged ≥75 years with a 55% probability of being cost-effective at a £30000 per QALY threshold. Molnupiravir would have to be priced around £147 per course to be cost-effective at a £15000 per QALY threshold. Conclusion: Molnupiravir at the current cost of £513 per course is unlikely to be cost-effective relative to usual care over a six-month time horizon among mainly vaccinated COVID-19 patients at increased risk of adverse outcomes, except those aged ≥75 years.

authors

  • Png, May Ee
  • Harris, Victoria
  • Grabey, Jenna
  • Hart, Nigel David
  • Jani, Bhautesh Dinesh
  • Butler, Daniel
  • Carson-Stevens, Andrew
  • Coates, Maria
  • Cureton, Lucy
  • Dobson, Melissa
  • Dorward, Jienchi
  • Evans, Philip
  • Francis, Nick
  • Gbinigie, Oghenekome Abisoye
  • Hayward, Gail
  • Holmes, Jane
  • Hood, Kerenza
  • Khoo, Saye
  • Ahmed, Haroon
  • Lown, Mark
  • Mckenna, Micheal
  • Mort, Sam
  • Nguyen-Van-Tam, Jonathan
  • Rahman, Najib
  • Richards, Duncan B
  • Thomas, Nicholas
  • van Hecke, Oliver
  • Hobbs, FD Richard
  • Little, Paul
  • Yu, Ly-mee
  • Butler, Christopher
  • Petrou, Stavros

publication date

  • January 16, 2024