Work

Nirmatrelvir/ritonavir treatment for COVID-19: an economic value systematic literature review

Year: 2025

Type: review

Abstract: Aims Nirmatrelvir/ritonavir (NMV/r)Footnote* is an antiviral drug used to treat mild-to-moderate coronavirus disease 2019 (COVID-19) in patients at high risk of progression to severe COVID-19. We conducted an economic systematic literature review to assess key parameters, structures, and outcomes of existing models and analyses of the economic value of NMV/r treatment.Methods A systematic search of Embase, MEDLINE, and MEDLINE In-Process, as well as bibliographies of systematic reviews and conference and health technology assessment websites, identified relevant articles published between 2022 and 2024. A quality assessment was conducted for each economic evaluation using the Drummond checklist.Results Of the 22 included economic evaluations, most were cost-utility analyses (n = 10) and cost-effectiveness analyses (n = 9). Most used a short-term decision tree with a long-term Markov model (n = 5), with time horizons between 28 days to a lifetime, and were from a healthcare system perspective (n = 7). Most conducted scenario analyses (n = 15) and/or sensitivity analyses (n = 18), and many based treatment effectiveness estimates on the Evaluation of Protease Inhibition for COVID-19 in High-Risk Patients (EPIC-HR) randomized controlled trial (n = 7). Overall, NMV/r showed economic value across different willingness-to-pay thresholds when compared with standard of care or best supportive care, and all economic evaluations were high or moderate quality.Limitations Most included economic evaluations were from high-income countries and all were written in English and may not be generalizable to low-income countries or healthcare systems.Conclusion While economic evaluations were heterogeneous in terms of modeling approach, population, treatments, and context, these findings indicate that NMV/r has economic value for patients with mild-to-moderate COVID-19 with a high risk of progression to severe disease. Significant changes to the burden of COVID-19 due to the evolution of COVID-19 variants and new vaccination strategies, may warrant updates models.

Source: Journal of Medical Economics

DOI: 10.1080/13696998.2025.2579407

Authors: Tendai Mugwagwa, José Marcano Belisario, Louise Hartley, Nguyen Thi Nhan Phan

Institutions: Pfizer (United Kingdom), RTI Health Solutions

Language: English

Topic: Health Systems, Economic Evaluations, Quality of Life

Subfield: Economics and Econometrics

Field: Economics, Econometrics and Finance

Domain: Social Sciences

SDG: Good health and well-being

Open Access status: diamond

Funder: Pfizer