OBJECTIVES: Remdesivir was developed as an intravenous antiviral treatment for hospitalized patients with moderate and severe Covid-19 and has been approved for emergency use in several countries including Europe. The objective is to perform a cost-effectiveness analysis of treatment with remdesivir in combination with standard of care (SoC) in hospitalized Covid-19 adult patients requiring supplemental oxygen in Greece versus SoC.

METHODS: A projected cohort-based model with a time horizon of 50 years formed the basis of the analysis. The model was populated with country-specific data. Clinical data were sourced from the ACTT-1 trial, cost data were sourced from literature, while resource use data were elicited from experts’ opinion through structured interviews. The analysis was conducted from a third-party payer perspective. Costs refer to year 2020. Both costs and outcomes were discounted at 3% per annum.

RESULTS: Remdesivir in combination with SOC was found to offer more LYg and QALYs compared to SoC (18.17 versus 16.72 and 13.80 versus 12.69 respectively). In addition, patients treated with remdesivir had 0.87, 1.49 and 1.37 less days of hospital stay in the general ward, intensive care unit (ICU) and ICU with mechanical invasive ventilation (MIV) settings respectively compared to patients treated only with SoC. Patients receiving remdesivir were estimated to incur savings of €1,742 compared to SoC. The ICER of remdesivir was estimated at -4,290.9 per QALY gained against SoC.

CONCLUSIONS: Remdesivir was found to be cost effective (dominating) in the Greek environment, as the treatment led not only to better clinical outcomes, but also in savings for the third payer. In addition, less length of hospital stay due to remdesivir can release hospital beds, especially crucial ICU beds, in times of pandemic outbreak.