OBJECTIVES: to estimate the budget impact (BI) of the oral treatment, nirmaltrevir+ritonavir, for mild-to-moderate coronavirus disease in adults who are at risk of progression to severe COVID-19 for the whole Argentinean health system.

METHODS: A budget impact model was adapted to the Argentinean context to estimate the BI using the perspective for the entire Argentinean health system with the MoH as the payer over three years. Target population was defined as adults with mild-to-moderate coronavirus disease with risk factors for progression to severe COVID-19 (obesity, diabetes, chronic pulmonary disease, chronic heart disease, chronic renal disease, and immunosuppression due to transplantation). Key parameters were estimated based on Argentinian epidemiological data, published papers and local expert opinion. Costs are expressed in USD (exchange rate 1USD=218,03 AR$, April 2023).

RESULTS: The reduction of hospitalizations estimated was -16,5%, -24,8% and -33% for each year and the reduction in deaths -906, -1359, and -1812 respectively. The net budget impact over three years for the inclusion of nirmaltrevir+ritonavir in the Argentinean health system was 78,2 M dollars (year 1), 117,3 M dollars (year 2) and 156.4 M dollars (year 3). The estimated BI per hospitalization averted was 4,231 USD in the first year, 2,821 in the second year and 2,115.31 in the third. Regarding the deaths averted, the estimated BI was 86,326 for year 1, 57551, for year 2 and 43,163 for year 3. The annual incidence of COVID 19 and the acquisition costs were the most influential parameters in the one way sensitivity analysis.

CONCLUSIONS: The incorporation of nirmaltrevir+ritonavir in the Argentinean health system would increase the budgetary impact with significant reduction of hospitalizations and deaths.