Interventions of Interest:
- molnupiravir (Lagevrio™, Merck)
- PF-07321332/ritonavir (Paxlovid™, Pfizer)
- fluvoxamine (Investigator initiated)
We have deemed this a “special assessment” since this is an early snapshot of emerging agents in the COVID-19 pipeline.
December 2022 Update
Dominant viral variants, vaccination/prior infection status, and evidence on Paxlovid continue to evolve, but ICER is presenting an update based on recent evidence to help inform new discussions on fair pricing for Paxlovid as coverage shifts from federal contracts to commercial insurer payment. New data suggests Paxlovid will achieve common thresholds of cost-effectiveness if priced between $563-$906 per treatment course.
Details of this update using the ICER Analytics™ platform have been posted for ICER Analytics subscribers to emphasize how individual insurers and health systems can input evolving data and cost structures to create a customized health benefit price benchmark.
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ICER President Steven Pearson, MD, MSc stated:
“The evidence on outpatient treatments for COVID-19 must be viewed as highly sensitive to the evolving landscape of COVID-19 variants and vaccination status in the US. As hospitalization rates due to COVID-19 rise or fall in the future due to changes in the COVID-19 landscape, the clinical value of Paxlovid will change accordingly. Nonetheless, with substantial new data now available from recent experience during the Omicron wave earlier this year, and with new negotiations underway on pricing and payment between commercial insurers and the manufacturer, we believe it will be helpful for all stakeholders to have updated calculations of a price that aligns with the evidence on benefits to patients.
We acknowledge that there are other paradigms of fair pricing that can be applied, particularly in pandemic environments, including analyses of fair profit over and above the cost of production, and considerations of the impact of treatment on broader societal factors such as business activity and education. For this reason, and with the evidence continuing to evolve rapidly, we want to encourage all stakeholders, including patient groups, payers, and drug makers, to use the ICER Analytics platform to apply their own judgment of the emerging evidence in support of a transparent discussion around value and fair pricing.”