Interventions of Interest:

  • remdesivir (VEKLURY®)

ICER released the results of its initial analyses to inform public debate of pricing for remdesivir (Gilead Sciences) and other future treatments of COVID-19. Working with external academic partners, ICER has developed ICER-COVID models comprising two alternative pricing paradigms for COVID-19 treatments: 1) “cost recovery” for the manufacturer, representing an estimate based on peer-reviewed methods of calculating the minimum costs of production for a course of therapy; and 2) traditional cost-effectiveness analyses looking at the incremental health benefits and costs within the health system. The models will be used to track and evaluate any potential future treatments for COVID-19. Click here to learn more about ICER’s adapted methods for assessing pricing during a pandemic.

Based on an analysis of four studies evaluating remdesivir’s influence on mortality, ICER has concluded that the totality of evidence no longer supports an assumption of survival benefit from remdesivir; however, new data from US-based ACTT-1 trial does support savings on insurer payment for hospital services .

Given these new data and remdesivir’s expanded label to include less severely ill patients, ICER now suggests a health-benefit price benchmark of $2,470 for hospitalized patients with moderate-to-severe disease, and $70 for patients hospitalized with milder disease.

New results, along with scenario analyses retaining survival benefit assumptions, will be shared with international health technology assessment agencies using the ICER-COVID model for policy making.

For questions, please contact info@icer.org.


Final Documents

Below you will find the final documents from the policy paper review process:

Recently Updated AssessmentDownload
Public CommentsDownload

According to our most recent COVID-19 update:

Based on an analysis of four studies evaluating remdesivir’s influence on mortality, ICER has concluded that the totality of evidence no longer supports an assumption of survival benefit from remdesivir; however, new data from US-based ACTT-1 trial does support savings on insurer payment for hospital services. Given these new data and remdesivir’s expanded label to include less severely ill patients, ICER now suggests a health-benefit price benchmark of $2,470 for hospitalized patients with moderate-to-severe disease, and $70 for patients hospitalized with milder disease.

New results, along with scenario analyses retaining survival benefit assumptions, will be shared with international health technology assessment agencies using the ICER-COVID model for policy making.

ICER President Steve Pearson, MD, MSc, stated:

We have previously noted that, as new treatments emerge for COVID-19, policymakers will need to track the evolution of the maturing data in order to understand the benefits that can be realized for patients and the health system. Remdesivir is an excellent case in point. Given the persuasive results from a new meta-analysis across trials, including SOLIDARITY, ICER’s model no longer assumes that remdesivir provides a significant survival benefit. We acknowledge that SOLIDARITY is an important part of this meta-analysis, that both SOLIDARITY and the meta-analysis still await peer review, and that additional US-based data are needed to fully support or reject a survival benefit. Other new data from a key trial in the US health care system does demonstrate that the clinical impact of treatment shortens hospital stays and reduces the number of patients with moderate-to-severe disease who require higher levels of respiratory support.

When incorporating all these new data, and in light of remdesivir’s expanded label to treat patients with more mild disease, our model suggests that remdesivir’s current US price is too high to align reasonably with its demonstrated benefits to patients. The current price would meet a key cost-effectiveness threshold only if it were used solely to treat patients hospitalized with moderate-to-severe disease and — importantly — only if one still assumes that remdesivir saves lives. We hope that further evidence does become available on remdesivir and that additional treatments are approved for which the benefits to patients can be demonstrated through well-conducted clinical trials.