OBJECTIVES:

This study aimed to estimate the ICU admission rate and related cost in patients taking Molnupiravir versus Nirmatrelvir+Ritonavir, the oral antiviral therapies to receive Emergency Use Authorization from the US FDA in December 2021 for the treatment of mild to moderate COVID-19 patients.

METHODS:

In this retrospective claim data study, Optum’s de-identified Clinformatics® Data Mart Database (Mainly Commercial and Medicare Advantage) is used to identify the patients who have been prescribed Molnupiravir or Nirmatrelvir+Ritonavir with NDC codes. The patient cohort is divided into two groups: one has been prescribed Molnupiravir and the other one has been prescribed Nirmatrelvir+Ritonavir. The patients in this study cohort have both medical and pharmacy claims. The study period is considered from the approval of these drugs, which is December 22nd and 23rd, 2021, to May 31st, 2022. The first fill date of the prescription for Molnupiravir and Nirmatrelvir+Ritonavir is considered the index date. All patients were followed for 30 days post index to look for any ICU admission and its related costs. The data was analyzed, and two tailed t-test and chi square test were applied.

RESULTS:

The percentage of patients who have been prescribed Molnupiravir is 25% (N= 4,851), while the patient cohort prescribed with Nirmatrelvir+Ritonavir is 75% (N= 14,479). Patients who have been prescribed Molnupiravir have a significantly higher ICU admission rate (1.2%) than patients who have been prescribed Nirmatrelvir+Ritonavir (0.2%) (P<0.001). The average cost related to ICU admission in patients who have taken Molnupiravir (mean-$15,439) does not show a difference from the cost of ICU admission in patients who have taken Nirmatrelvir+Ritonavir (mean-$13,383) (P = 0.72).

CONCLUSIONS: This study shows that the ICU admission rate is noticeably different in the cohort of patients taking Molnupiravir compared to the Nirmatrelvir+Ritonavir combination, where ICU-related costs are almost similar in both the cohorts.