OBJECTIVES: The efficacy and safety of remdesivir (RDV) as treatment of hospitalized patients with COVID-19 have been studied in several well-conducted randomized controlled trials. Given the evidence of the clinical benefits, a cost-effectiveness analysis (CEA) in countries with high resources constraints is critical for determining optimal healthcare resource utilization. This study provides a CEA of RDV for COVID-19 treatment compared to standard of care (SoC) in hospitalized patients in Argentina, Chile, and Colombia.

METHODS: A model combining an initial decision tree for the individual’s time in the hospital and a lifetime Markov process was implemented. Patients enter the model when hospitalization and treatment begin. In the first stage, patients were followed for 28 days during the hospital stay. Patients transition according to their ordinal category score to discharged or transferred to a different ward or death. Alive patients at the end of the decision-tree phase, enter a lifetime Markov model subject to national age-adjusted mortality. Costs were gathered from the respective national sources for public settings. Health outcomes (Life-Years Gained -LYG) and costs were discounted following international recommendations. Deterministic and probabilistic sensitivity analyses were conducted.

RESULTS: The ICER was calculated by country, comparing RDV with SoC. RDV provided a higher LYG than SoC in the three countries, with an additional investment due to the cost of the medicine. RDV was a cost-effective intervention in the three countries. (ICER: Colombia =671.3 USD per LYG, Chile= 1,237 USD per LYG, and Argentina = 994.8USD. Results were consistent for all sensitivity scenarios remaining RDV as a cost-effective option.

CONCLUSION: RDV is cost-effective in the three different settings in treating hospitalized adults with COVID-19 in three countries in Latin America. Besides, by lowering hospital stay, RDV provides additional indirect benefits by alleviating the demand for ICU beds.