Background: In the United Arab Emirates, 740,432 cases of COVID-19 have been reported to date, with 2,140 deaths. Given limited resources, it is important to understand the value for money of treatments, especially for hospitalized patients. This study investigated the cost-effectiveness of UAE guideline-recommended remdesivir (RDV) and favipiravir (FAVI) for treating patients who require low-flow supplemental oxygenation compared to standard of care (SOC).

Methods: Using local epidemiology and guidelines, as well as clinical efficacy data from the literature, a cost-effectiveness model was built to estimate the treatment impact on mortality, hospital bed days, costs and cost per outcome over a one-year period. Different epidemiological and mortality scenarios were evaluated as UAE has a relatively low case-fatality rate.

Results: The model estimated that use of RDV+SOC resulted in fewer deaths (343 – 371) and substantially fewer hospital general ward days (3,951 – 15,785), ICU days (6,781 – 7,003), and MIV days (5,597 – 9,890) when compared to either FAVI+SOC or SOC alone. Additionally, the model estimated RDV use resulted in potential cost savings of USD 3,454 per patient compared to SOC alone (USD 3,532 versus FAVI+SOC). The model was sensitive to clinical data on time to recovery and cost of hospital bed days but maintained incremental clinical, health care resource use (HCRU) and cost benefits for RDV+SOC versus the comparators across all scenarios.

Conclusions: This model estimated that the use of RDV+SOC in hospitalized COVID- 19 patients requiring supplemental oxygen reduced mortality, clinical progression, and length of stay, resulting in reductions in healthcare resource use and cost savings. The model did seem to overestimate mortality in the base-case, but adjusting for local mortality rates still showed incremental benefit for RDV+SOC. It should be noted that the clinical data on FAVI is limited and we should interpret these results with caution.