To assess the budget impact metrics of prescribing nirmatrelvir-ritonavir (NR) for COVID-19 treatment in the Veterans Health Administration (VHA) for treatment-eligible Veterans.
Key Findings:
18% of treatment-eligible Veterans were prescribed NR, indicating potential underutilization.
Treating all patients reduced healthcare costs by $20 million but increased total budget costs by $122 million due to NR purchasing costs, highlighting the financial trade-offs.
Targeted treatment of high-risk patients resulted in healthcare cost savings of $17 million with a modest total budget increase of $3 million, suggesting a more efficient allocation of resources.
Interpretation:
NR may lower healthcare utilization costs associated with COVID-19, but its high purchasing cost likely outweighs these savings, necessitating price reductions for financial viability and sustainable treatment options.
Limitations:
Real-world effectiveness of NR may vary, affecting budget impact estimates, particularly in diverse patient populations.
Broad eligibility criteria may lead to treatment of patients with marginal benefits, complicating cost-effectiveness assessments.
Conclusion:
Risk-informed allocation strategies are essential to maximize treatment benefits while minimizing budget increases; price reductions for NR are crucial for its sustainable use in healthcare systems, especially under budget constraints.
by David P Bui, Denise M Hynes, Edwin Wong, Robert Vergun, Lei Yan, Yuli Li, Nallakkandi Rajeevan, Kristin Berry, Hung-Mo Lin, Yuan Huang, Diana J Govier, Mihaela Aslan, George Ioannou, Kristina L Bajema
