Skip to main content

ORIGINAL RESEARCH article

Front. Public Health
Sec. Health Economics
Volume 12 - 2024 | doi: 10.3389/fpubh.2024.1432821

Real-world cost-effectiveness of nirmatrelvir-ritonavir as treatment for SARS-CoV-2 infection in the Belgian setting with omicron-variant

Provisionally accepted
Sophie Marbaix Sophie Marbaix 1,2*Steven Simoens Steven Simoens 3Philippe Clevenbergh Philippe Clevenbergh 4Pascal Van Bleyenbergh Pascal Van Bleyenbergh 5Keliane Liberman Keliane Liberman 6Dimitri Dehenau Dimitri Dehenau 7
  • 1 SNB management, Soignies, Belgium
  • 2 Faculty of Medicine and Pharmacy, Research Institute for Health Sciences and Technology, University of Mons - Umons, Mons, Belgium
  • 3 Department of Pharmaceutical and Pharmacological Sciences, Faculty of Medicine, KU Leuven, Leuven, Belgium
  • 4 Head of Infectious Diseases Department, CHU Brugmann, Brussels, Belgium
  • 5 Head of Pneumology Department, KU Leuven, Leuven, Belgium
  • 6 Medical Department, Pfizer, Brussels, Belgium
  • 7 Other, Brussels, Belgium

The final, formatted version of the article will be published soon.

    Background: Nirmatrelvir-ritonavir is an oral treatment for SARS-CoV-2 infection in patients who are at high risk of developing severe COVID-19 disease. This antiviral has proven to significantly reduce the risk of hospitalization and death compared to no anti-SARS-CoV-2 treatment in this target population. This paper aims to assess the cost-effectiveness of nirmatrelvir-ritonavir in Belgium using real-world evidence. Methods: A static decision tree model was developed to capture the health progression of patients infected with the SARS-CoV-2 virus. Outcomes were expressed in Quality Adjusted-Life Years (QALYs), hospitalizations, Intensive Care Unit (ICU) admissions, deaths and Long Covid cases, derived from epidemiological data over the first full year of the Omicron variant's circulation (2022). Costs were calculated for the year 2023 from the healthcare payer's perspective. Extensive sensitivity analyses were conducted to test the robustness of cost-effectiveness results. Results: In a cohort of 1,000 patients, treatment with nirmatrelvir-ritonavir is projected to save 95 QALYs and €82,658 compared to no anti-SARS-CoV-2 treatment over a lifetime horizon. These savings primarily stem from the reduction in hospitalizations among vulnerable patients who typically require a longer recovery time. The analysis also indicates 5 fewer ICU admissions and 8 fewer premature deaths per 1,000 infected patients. Conclusions: In the context of Omicron SARS-CoV-2 infection, administering nirmatrelvir-ritonavir to patients at high risk of severe disease improves health outcomes and reduces costs. Nirmatrelvir-ritonavir is 100% likely to be cost-effective at a willingness to pay of €2,000 per QALY.

    Keywords: Cost-utility, SARS-CoV-2, Antiviral treatment, Belgium, High-risk persons

    Received: 14 May 2024; Accepted: 27 Dec 2024.

    Copyright: © 2024 Marbaix, Simoens, Clevenbergh, Van Bleyenbergh, Liberman and Dehenau. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Sophie Marbaix, SNB management, Soignies, Belgium

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.