CLINICAL BENEFITS OF NIRMATRELVIR/RITONAVIR TREATMENT FOR COVID-19: A GLOBAL ECONOMIC VALUE SYSTEMATIC LITERATURE REVIEW
Author(s)
Tendai Mugwagwa, PhD1, Jose Marcano Belisario, PhD2, Louise Hartley, PhD2, Nguyen Thi Nhan Phan, MPH2, Ruth Mokgokong, PhD1.
1Pfizer Ltd, Tadworth, United Kingdom, 2RTI Health Solutions, Manchester, United Kingdom.
1Pfizer Ltd, Tadworth, United Kingdom, 2RTI Health Solutions, Manchester, United Kingdom.
OBJECTIVES: Nirmatrelvir+ritonavir (NMV/r) is an antiviral drug indicated for the treatment of patients with mild to moderate coronavirus disease 2019 (COVID-19) who are at high risk of progressing to severe disease. We conducted an economic systematic literature review and examined non-monetary outcomes associated with NMV/r, including subgroup effects stratified by vaccination status and on post-COVID conditions.
METHODS: We performed a systematic search of Embase, PubMed, Cochrane, and EconLit and of conference and health technology assessment agency websites to identify economic analyses published between January 2022 and October 2025.
RESULTS: A total of 33 economic analyses were included. Studies were conducted across the Americas (n=12), Asia (n=8), Europe (n=12), and Africa (n=1). Most included cost-utility analyses (n=17) and used a short-term decision tree with a long-term Markov model (n=11). Of those that conducted scenarios analyses (N=27), most assessed the impact of long COVID/post-acute COVID/post-COVID conditions (n=9) and vaccination status (n=9) on outcomes. NMV/r was found to be cost-effective at different willingness-to-pay thresholds when compared with comparator treatments. Among studies reporting non-monetary endpoint availability (N=20), almost all reported hospital-related outcomes (n=19), and some reported intensive care unit-related endpoints (n=8), symptom days (n=4), and death-related endpoints (n=14). Of these, several reported reduced hospitalizations (n=18), intensive care unit admissions (n=8), symptom days (n=4), and lower mortality (n=12). In a static decision tree model that used a hypothetical cohort of 1,000 patients, NMV/r reduced healthcare costs associated with long COVID complications by €3,444 over a 1-year time horizon compared with no specific COVID-19 treatment.
CONCLUSIONS: In addition to monetary benefits, NMV/r provides non-monetary benefits to patients with mild to moderate COVID-19, including reduced hospitalizations, intensive care unit admissions, symptoms days, and lower mortality. Taken together, this study provides further support for NMV/r as a cost-effective treatment option.
METHODS: We performed a systematic search of Embase, PubMed, Cochrane, and EconLit and of conference and health technology assessment agency websites to identify economic analyses published between January 2022 and October 2025.
RESULTS: A total of 33 economic analyses were included. Studies were conducted across the Americas (n=12), Asia (n=8), Europe (n=12), and Africa (n=1). Most included cost-utility analyses (n=17) and used a short-term decision tree with a long-term Markov model (n=11). Of those that conducted scenarios analyses (N=27), most assessed the impact of long COVID/post-acute COVID/post-COVID conditions (n=9) and vaccination status (n=9) on outcomes. NMV/r was found to be cost-effective at different willingness-to-pay thresholds when compared with comparator treatments. Among studies reporting non-monetary endpoint availability (N=20), almost all reported hospital-related outcomes (n=19), and some reported intensive care unit-related endpoints (n=8), symptom days (n=4), and death-related endpoints (n=14). Of these, several reported reduced hospitalizations (n=18), intensive care unit admissions (n=8), symptom days (n=4), and lower mortality (n=12). In a static decision tree model that used a hypothetical cohort of 1,000 patients, NMV/r reduced healthcare costs associated with long COVID complications by €3,444 over a 1-year time horizon compared with no specific COVID-19 treatment.
CONCLUSIONS: In addition to monetary benefits, NMV/r provides non-monetary benefits to patients with mild to moderate COVID-19, including reduced hospitalizations, intensive care unit admissions, symptoms days, and lower mortality. Taken together, this study provides further support for NMV/r as a cost-effective treatment option.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE76
Topic
Economic Evaluation
Disease
SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)