Antivirals used to treat people with mild-to-moderate Covid-19 are considered reasonably priced, according to a new preliminary assessment published by the Institute for Clinical and Economic Review.
The 199-page report published by the independent nonprofit on Thursday analyzes cost-effectiveness based mostly on how well the medicines help a high-risk patient avoid the cost of hospitalization. The report also takes into account other benefits, like how the medicines can help stop the spread of the virus. Fewer cases mean fewer crowded hospitals and fewer expenses, although those aren’t as easy to estimate and may not be fully captured in the economic model, according to the report.
The information is based predominantly on information in countries outside of the US, since the landscape “has been evolving so rapidly,” the report says they are still gathering and analyzing US data.
The report looks at the prices for new antivirals — Pfizer’s Paxlovid and Merck’s molnupiravir — and GlaxoSmithKline and Vir Biotechnology’s sotrovimab, the only remaining monoclonal antibody that works against the Omicron variant of the coronavirus. It also assesses a repurposed antidepressant called fluvoxamine that some studies suggest may be effective at treating coronavirus symptoms, although other studies have not found that it makes a difference. The FDA still has not decided if fluvoxamine should have an emergency use authorization to treat Covid-19.
The monoclonal treatment is most expensive at $2,100 a dose. The cost does not include the fees that come with administering or monitoring the treatment. Molnupiravir is $707, Paxlovid is $529 and the repurposed drug fluvoxamine is $12 a treatment course, according to the report.
Eligible patients in the US can receive these treatments free of charge during the public health emergency.
The study used a benchmark called quality-adjusted life year that measures the quality of the years a person has remaining and life expectancy. Compared to usual care, the assessment found that the cost per year life gained is $58,000 for sotrovimab, $46,000 for molnupiravir, $15,000 for Paxlovid and $5,000 for fluvoxamine.
The authors of the report said this assessment is preliminary since the prices are based on factors that could change dramatically. For instance, companies could raise the prices of these drugs. And if another variant comes along that causes milder illness, that could also change the value of the drug. If a variant sends more people to the hospital, then the value of the drugs would increase.
The study also has limitations since it was completed prior the spike in cases due to the Omicron variant. The data was also based on overseas and unvaccinated patients.
For now, the report concludes “at their current negotiated price (sotrovimab, molnupiravir, and Paxlovid) or their generic market price (fluvoxamine), these drugs appear — at this time — to have prices reasonably aligned with patient benefits.”
