Remdesivir Reduced Healthcare Resource Utilization in Patients Hospitalized With COVID-19 During the Omicron-Dominant Period

OBJECTIVES: Healthcare resource utilization (HCRU) for COVID-19 patients is both cost and labor-intensive. Patients with COVID-19 are hospitalized for an average of 7 days, costing up to $1,000/day. Here, we evaluated the comparative effectiveness of remdesivir (RDV) treatment on HCRU in patients hospitalized with COVID-19 during the Omicron-dominant period.

METHODS: This was a retrospective observational cohort study using health insurance claims from the US HealthVerity database. Patients were aged ≥18 years, were hospitalized with a primary diagnosis of COVID-19 from December 1, 2021, to April 30, 2023, had ≥12 months of prior claims enrollment, and received either ≥1 dose of RDV or did not receive RDV (comparator group) at any time during hospitalization. Patients were followed from index date (RDV initiation or distribution of days from hospital admission to start of RDV treatment for the comparator) to the earliest: death, end of study period, or hospital discharge. Baseline covariate differences between cohorts were balanced by propensity score matching (PSM). Generalized linear models were used to compare the total hospital or ICU billed amount and length of stay (LOS) between groups.

RESULTS: Overall, 32,571 patients met study criteria and were included. After PSM, 7,427 patients were matched (1:1) in both groups. Participant demographics were well-balanced between groups. The median (IQR) follow-up was 6 (7) days in both groups. Between the RDV and comparator groups, the mean (95% CI) hospital admission costs ($20,289.62 [$20,288.53 - $20,290.93] vs $21,347.39 [$21,346.37-$21,348.63]) and hospital LOS (9.4 [9.4-9.5] vs 9.6 [9.6-9.7] days) were lower for the RDV group. Mean ICU cost and LOS were also lower for the RDV group than for comparators.

CONCLUSIONS: In this real-world cohort of patients hospitalized with COVID-19 during Omicron, RDV was associated with a lower average hospital cost and LOS for overall hospital admission, as well as for the ICU.