A Model-Based Cost-Effectiveness Analysis of Long-Acting Monoclonal Antibody (Tixagevimab and Cilgavimab: Evusheld) Preventive Treatment for High-Risk Populations Against SARS- CoV-2 in Koreaopen access
- Authors
- Jo, Youngji; Kim, Sun Bean; Jung, Jaehun
- Issue Date
- Aug-2023
- Publisher
- KOREAN ACAD MEDICAL SCIENCES
- Keywords
- SARS-Cov-2; COVID-19; Cost-Effectiveness Analysis; Evusheld
- Citation
- JOURNAL OF KOREAN MEDICAL SCIENCE, v.38, no.32, pp.1 - 14
- Journal Title
- JOURNAL OF KOREAN MEDICAL SCIENCE
- Volume
- 38
- Number
- 32
- Start Page
- 1
- End Page
- 14
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/89066
- DOI
- 10.3346/jkms.2023.38.e250
- ISSN
- 1011-8934
- Abstract
- Background: Tixagevimab and cilgavimab (Evusheld) administration is a recommended strategy for unvaccinated patients with immunocompromised conditions and severe allergic reaction conditions to protect high-risk individuals and control the coronavirus disease 2019 (COVID-19) epidemic. We estimated the cost-effectiveness of Evusheld in key risk populations: 1) immunocompromised (vaccinated/unvaccinated), 2) severe allergic reaction, and 3) unvaccinated elderly high-risk groups. Methods: Based on the estimated target risk group population, we used a model of COVID-19 transmission to estimate the size of the risk group population for whom Evusheld treatment may help prevent symptomatic COVID-19 (and deaths) in 2022. We projected Evusheld intervention costs, quality-adjusted life year (QALY) lost, cost averted and QALY gained by reduced COVID-19 incidence, and incremental cost-effectiveness (cost per QALY gained) in each modeled population from the healthcare system perspective. Results: Our study demonstrated that Evusheld treatment for COVID-19 infection in South Korea is highly cost-effective for unvaccinated risk groups ($18,959 per QALY gained for immunocompromised and $23,978 per QALY gained for high-risk elderly groups) and moderately cost-effective among individuals who are vaccinated immunocompromised ($46,494 per QALY gained), or have severe allergic reactions ($45,996 per QALY gained). Evusheld's cost-effectiveness may be subject to risk-group-specific COVID-19 disease progression and Evusheld efficacy and cost, which may change in future epidemic scenarios. Conclusion: As the COVID-19 variants and risk group-specific durable efficacy, toxicity (and/ or resistance) and optimal dosing of Evusheld remain uncertain, better empirical estimates to inform these values in different epidemiological contexts are needed. These results may help decision-makers prioritize resources toward more equitable and effective COVID-19 control efforts.
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