Healthcare Utilization Among COVID-19 Patients Treated With Nirmatrelvir/Ritonavir in Taiwan: A Nationwide Population-Based Cohort Study
Author(s)
Raymond Kuo, PhD1, WANCHI CHEN, MSc1, Yu-Hsuan Kuo, MSc, PharmD2, Kuan-Ling Kuo, PhD2, Chih-Chi Yang, MSc3, Yi-Chun Yeh, PhD3, Wen-Yi Shau, PhD, MD4.
1Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan, 2Real World Solutions, IQVIA Solutions Taiwan, Taipei, Taiwan, 3Real World Solutions, IQVIA, Taipei, Taiwan, 4Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
1Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan, 2Real World Solutions, IQVIA Solutions Taiwan, Taipei, Taiwan, 3Real World Solutions, IQVIA, Taipei, Taiwan, 4Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
OBJECTIVES: Nirmatrelvir and ritonavir, an oral combination treatment, is indicated for mild-to-moderate symptomatic COVID-19 patients at higher risk for severe disease. Clinical trials have shown a significant reduction in COVID-19-related events with this treatment, and it has been widely prescribed at public expense during the pandemic in Taiwan since 2022. This study aimed to evaluate the healthcare resource utilization among patients receiving nirmatrelvir/ritonavir in Taiwan.
METHODS: The National Health Insurance Research Database (NHIRD) was utilized to identify patients who were first prescribed nirmatrelvir/ritonavir during outpatient visits in 2022, with costs covered by government funding. Patients without a COVID-19 diagnosis at the time of receiving the treatment were excluded. Baseline characteristics and real-world healthcare resource utilization, such as hospitalization and ICU admission, were analyzed.
RESULTS: A total of 806,620 patients were enrolled, with 58.6% aged 65 or older and 92.2% having received at least one COVID-19 vaccination. Among vaccinated patients, 46.9% received nirmatrelvir/ritonavir within 6 months of vaccination, while 53.1% received it 6 months or more after vaccination. Specifically, 15,330 patients (1.9%) were hospitalized, with an ICU admission rate of 11.7% and a hospitalized mortality rate of 8.6%. After stratification, 6.3% of the unvaccinated population were hospitalized, of whom 13.7% were admitted to ICU and 13.0% deceased. In contrast, only 1.5% of the vaccinated population were hospitalized, of whom 11.0% and 7.0% experienced ICU admission and death, respectively. The average hospitalization duration was 7.82 days for patients who stayed in general wards and 17.72 days for those admitted to the ICU, with daily costs of NTD $8,791 and $6,432, respectively.
CONCLUSIONS: The study described the healthcare utilization of the population treated with nirmatrelvir/ritonavir on a cohort level in Taiwan, including hospitalization rate and mortality rates.
METHODS: The National Health Insurance Research Database (NHIRD) was utilized to identify patients who were first prescribed nirmatrelvir/ritonavir during outpatient visits in 2022, with costs covered by government funding. Patients without a COVID-19 diagnosis at the time of receiving the treatment were excluded. Baseline characteristics and real-world healthcare resource utilization, such as hospitalization and ICU admission, were analyzed.
RESULTS: A total of 806,620 patients were enrolled, with 58.6% aged 65 or older and 92.2% having received at least one COVID-19 vaccination. Among vaccinated patients, 46.9% received nirmatrelvir/ritonavir within 6 months of vaccination, while 53.1% received it 6 months or more after vaccination. Specifically, 15,330 patients (1.9%) were hospitalized, with an ICU admission rate of 11.7% and a hospitalized mortality rate of 8.6%. After stratification, 6.3% of the unvaccinated population were hospitalized, of whom 13.7% were admitted to ICU and 13.0% deceased. In contrast, only 1.5% of the vaccinated population were hospitalized, of whom 11.0% and 7.0% experienced ICU admission and death, respectively. The average hospitalization duration was 7.82 days for patients who stayed in general wards and 17.72 days for those admitted to the ICU, with daily costs of NTD $8,791 and $6,432, respectively.
CONCLUSIONS: The study described the healthcare utilization of the population treated with nirmatrelvir/ritonavir on a cohort level in Taiwan, including hospitalization rate and mortality rates.
Conference/Value in Health Info
2025-09, ISPOR Real-World Evidence Summit 2025, Tokyo, Japan
Value in Health Regional, Volume 49S (September 2025)
Code
RWD299
Topic Subcategory
Health & Insurance Records Systems
Disease
SDC: Infectious Disease (non-vaccine)