The Costs of Oral Antiviral Delivery in UK Clinical Practice: Expert Opinion Survey

OBJECTIVES: To determine the time requirements and associated costs of drug-drug interaction (DDI) assessment and overall administration of oral antivirals, including those for the treatment of COVID-19 in clinical practice.

METHODS: The survey was distributed to healthcare professionals (HCPs) with specialities relevant to oral antivirals. Survey questions included DDI review time and overall review and dispensing time requirements of oral antivirals for COVID-19, human immunodeficiency virus (HIV) and other indications in a primary care environment. Weighted averages were calculated for time requirement for DDI review and overall clinical review, prescribing and dispensing time for both standard and complex patients. HCP responses for role conducting DDI review were mapped to Personal Social Services Research Unit (PSSRU) derived hourly rates and weighted average costs of responses were calculated (weighted average time requirement*weighted average NHS role hourly cost) (PSSRU 2023).

RESULTS: 36 HCPs responded to the questions relating to COVID-19, 25 responding to questions on HIV, and 23 to questions on oral antiviral administration in other indications. Overall DDI review time across indications was ≤15 minutes in standard patients and ≤45 minutes in complex patients. The majority of HCPs agreed that the overall clinical review, prescribing and dispensing of oral antivirals across indications takes ≤30 minutes in standard patients and ≤1 hour in complex patients. The cost of DDI review for oral antivirals for standard and complex patients with COVID-19 were £42.94 and £85.88, respectively. The cost of overall clinical review, prescribing and dispensing of oral antivirals for standard and complex patients with COVID-19 were £78.94 and £113.58, respectively.

CONCLUSIONS: These costs may be used by payers to validate administration and DDI associated costs for oral antivirals in economic models.