@article{01JHQ9CG0NEA6D2YR1XWR71HE9,
  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 6 months. Design and setting An economic evaluation of the PANORAMIC trial in the UK. Method A cost-utility analysis that adopted a UK NHS and personal social services perspective and a 6-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 pound (95% confidence interval [CI] = 445 to 453) and higher mean QALYs of 0.0055 (95% CI = 0.0044 to 0.0067) than usual care (mean incremental cost per QALY of 81 pound 190). Sensitivity and subgroup analyses showed similar results, except for those aged >= 75 years, with a 55% probability of being cost-effective at a 30 pound 000 per QALY threshold. Molnupiravir would have to be priced around 147 pound per course to be cost-effective at a 15 pound 000 per QALY threshold. Conclusion At the current cost of 513 pound per course, molnupiravir is unlikely to be cost-effective relative to usual care over a 6-month time horizon among mainly vaccinated patients with COVID-19 at increased risk of adverse outcomes, except those aged >= 75 years.}},
  author       = {{Png, May Ee and Harris, Victoria and Grabey, Jenna and Hart, Nigel D and Jani, Bhautesh D and Butler, Daniel and Carson-Stevens, Andrew and Coates, Maria and Cureton, Lucy and Dobson, Melissa and Dorward, Jienchi and Evans, Philip and Francis, Nick and Gbinigie, Oghenekome A and Hayward, Gail and Holmes, Jane and Hood, Kerenza and Khoo, Saye and Ahmed, Haroon and Lown, Mark and McKenna, Micheal and Mort, Sam and Nguyen-Van-Tam, Jonathan S and Rahman, Najib M and Richards, Duncan B and Thomas, Nicholas PB and Van Hecke, Oliver and Hobbs, Richard and Little, Paul and Yu, Ly-Mee and Butler, Christopher C and Petrou, Stavros and on behalf of the PANORAMIC Trial Collaborators, [missing]}},
  issn         = {{0960-1643}},
  journal      = {{BRITISH JOURNAL OF GENERAL PRACTICE}},
  keywords     = {{antiviral drugs,cost-benefit analysis,COVID-19,molnupiravir,quality- adjusted life years,SARS-CoV-2,HEALTH}},
  language     = {{eng}},
  number       = {{745}},
  pages        = {{E570--E579}},
  title        = {{Cost-utility analysis of molnupiravir for high-risk, community-based adults with COVID-19 : an economic evaluation of the PANORAMIC trial}},
  url          = {{http://doi.org/10.3399/bjgp.2023.0444}},
  volume       = {{74}},
  year         = {{2024}},
}

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