OBJECTIVES: In the ACTT-1 study in hospitalized adults with laboratory confirmed COVID-19, remdesivir was found to be superior to placebo in shortening time to recovery from COVID-19. However, the economic value and health system impact of remdesivir treatment is still unclear. This study evaluated remdesivir’s long-term cost-effectiveness and impact on health system capacities versus standard of care (SoC) for hospitalized COVID-19 patients in the United States (US).

METHODS: A hybrid decision-tree and Markov model simulated health and economic outcomes for hospitalized adult COVID-19 patients (average age of 58.9 years) from a US health system perspective over a lifetime horizon. Clinical inputs (e.g., hospitalization duration, mortality) were extracted from the ACTT-1 trial and real-world data. Cost inputs were sourced from an internal analysis or from the literature. Remdesivir acquisition cost was $390/vial, and patients were assumed to receive 6.25 vials per treatment course. One-way and probabilistic sensitivity analyses were performed. A separate treatment capacity analysis was performed on a national scale, assuming a population of 328,200,000 and one monthly incident cohort of 201,000 patients eligible for treatment.

RESULTS: Relative to SoC, remdesivir was associated with a decrease in total costs (savings of $8,844.49 per patient), increased life years (+0.62), and quality-adjusted life years (+0.47). Remdesivir was therefore dominant versus SoC (less costly and more effective). Results were robust in one-way and probabilistic sensitivity analyses. In the treatment capacity analysis, remdesivir increased the available hospital capacity by 1.4%, available ICU capacity by 32.1%, and total ventilator capacity by 2.3%.

CONCLUSIONS: Remdesivir is a cost-effective option for the treatment of patients hospitalized with mild, moderate, and severe COVID-19 versus SoC. In addition, due to its demonstrated ability to shorten time to recovery, remdesivir is projected to increase treatment capacity by increasing the percentage of available hospital bed-, ICU bed-, and total ventilator capacity.